Replantation in the pediatric hand is not an uncommon procedure, and it is 1 of the most common microsurgical operations in children. Microsurgeons should be aware of the indications and technical issues involving pediatric patients because there are differences compared to adult patients. In general, pediatric patients can be approached in a liberal and aggressive manner, but they tend to be more technically challenging. This review attempts to describe the various considerations in dealing with these patients to provide a framework for surgical management. Based on a survey of the literature, replantation has been a successful procedure in the pediatric population and has become a mainstay of treatment because it provides a better functional and aesthetic outcome.