For over 100 years obstructive sleep apnea has been recognized as a clinical entity in adults and more recently in children. A comprehensive review of the literature of pediatric obstructive sleep apnea was conducted using a PubMed search for original research articles. Bibliographies of these articles were reviewed for additional relevant articles not identified by the initial PubMed search. This article reviews the epidemiology, pathogenesis and risk factors, clinical features, diagnostic evaluation and treatment of obstructive sleep apnea in children. All physicians who provide care for children should be aware of the unique features of obstructive sleep apnea in children and the appropriate management.