Trauma has a significant impact on pediatric morbidity and mortality. Depending on the emergency medical services and health care system, anesthesiologists may be involved in pediatric trauma care at the scene, in the emergency department, in the operating room, or in the intensive care unit. Familiarity with the pathophysiology of pediatric trauma and age-dependent anatomical and physiological features is, therefore, essential to every anesthesiologist. Fast and appropriate interventions with respect to the clinical status and the suspected injuries are the key to successful treatment. Due to the high incidence of head injury, airway management and hemodynamic stabilization are of utmost importance. For preclinical trauma care, however, evidence-based data showing a gold standard for pediatric trauma care are still lacking.