Events such as the 1995 Oklahoma City bombing and the 2004 terrorist attack on the school in Beslan, Russia demonstrate that terrorists are willing and able to attack large numbers of children. Moreover, pediatric casualties are likely when terrorist incidents occur in urban areas even if children are not the primary target. Very little research has been conducted on the management and outcomes of children during and after disasters. This paper discusses the known risks that terrorism brings to children, vulnerabilities in this population, basic principles of pediatric disaster response and current gaps in response capabilities.