The prevalence of obstructive sleep apnea (OSA) is clearly increasing in the pediatric population. However, the polysomnographic criteria for treatment still remain to be defined by appropriate scientific methodology. Furthermore, the overall efficacy of currently available interventions such as surgical removal of enlarged tonsils and adenoids (T&A) is unknown, such that we are currently unable to precisely define who the high risk patients are, and the cost and benefits associated with any given treatment. Here, we review the available approaches to the management of OSA in the pediatric population, and examine the potential complementary role of anti-inflammatory therapy, mask ventilation, and intra-oral appliances in the context of mild OSA or residual OSA following T&A.