The development of patient controlled analgesia (PCA) in children is the result of a search for an analgesia being both maximally efficient and secure, in the management of severe pain. The technique is based on self infusions of an analgesic, mainly morphine, by the child, through a special pump. The quality of the pump is essential in order to exclude any risk of overdosage. In order to prevent potential secondary effects and complications, a careful supervision is mandatory (clinical, by pulse oximetry, regular checking of pump parameters). PCA is applicable to children older than 5 years. The main indications are post-operative and oncological pains.