Invasive fungal infections are important causes of morbidity and mortality in immunocompromised children. The past two decades have seen a dramatic increase in both number and overall relevance of invasive fungal infections in the hospital. At the same time, however, improved microbiological and imaging techniques together with an increased awareness have shifted the diagnosis of fungal infections from the autopsy theatre to the bedside. Major advances have been made in the definition of fungal diseases, the algorithms of antifungal interventions, the design and implementation of clinical trials and the development of standardized in vitro susceptibility testing. Most importantly, however, an array of new antifungal agents has entered the clinical arena and has made antifungal therapy more safe, more effective, but also more complicated. This article reviews some unique features of invasive fungal infections in infants and children and provides an update on the pharmacology of antifungal therapeutics in the pediatric population.

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