A growing number of pediatric Emergency Department (ED) patients has become increasingly common in recent years, but only a small number of them are in true emergencies. It is particularly important to use pediatric triage systems to quickly assess the patients' conditions and determine the patients' priority in emergency treatment, ensuring timely treatment to critically ill patients and efficient utilization of medical resources. The Canadian Triage and Acuity Scale Paediatric Guidelines (PaedCTAS), Australasian Triage Scale (ATS), Emergency Severity Index (ESI), and Manchester Triage System (MTS) are internationally recognized pediatric triage systems. Some countries, such as China, Thailand, Singapore, Norway, South Africa, and South Korea, have created their own pediatric emergency triage systems in line with the situation of their respective countries. Pediatric Assessment Triangle (PAT) and Pediatric Early Warning Signs (PEWS) are usually used with triage systems for quick initial assessment of pediatric ED patients. The pediatric emergency triage systems developed in different countries have good reliability and are suitable for pediatric emergency triage. Because different triage systems had different performances, it is advisable to research the factors influencing the performance of pediatric triage systems. This was a narrative review. This article aims to review the roles and implementation of pediatric emergency triage systems in China and other countries.