Tuberculosis (TB) is a social disease with medical implications. An estimated one-third of the world's population (2 billion people) is infected with the tubercle bacilli. In the year 2000 alone, an estimated 8.3 million new cases of TB occurred, of which 884,019 (10.7%) were in children. Of the total, 659,379 (75%) occurred in 22 high-burden countries, most of which were resource-poor. Despite a growing body of literature demonstrating the substantial impact made by addressing childhood TB, current guidelines are geared toward the treatment and control of TB in adults. This review focuses on TB disease among children younger than 15 years of age, the standard World Health Organization category for TB in children. The purpose of this work is to review the epidemiology, pathophysiology, and clinical presentation of childhood TB. The challenges of accurate surveillance, confirmation of diagnoses, and effective treatment of childhood TB in resource-poor settings are highlighted.