Cisplatin and carboplatin are important drugs in the treatment of childhood cancers. Extensive data for carboplatin, and more limited results with cisplatin, indicate that there is significant inter-patient pharmacokinetic variability such that adaptive dosing may be necessary for the optimal use of these drugs. Glomerular filtration rate based dosing formulae have been developed for carboplatin and their use is reviewed. Further studies are needed with cisplatin in order to define the reasons for inter-patient pharmacokinetic variability and its relevance in clinical practice. Only very limited data are available on the clinical or molecular pharmacodynamics of cisplatin and carboplatin in paediatric patients. By analogy with adult studies, pharmacologically-guided platinum complex treatment should offer significant advances over empiric dosing.