Purpose of Review <p> Biologic therapies have transformed treatment for children and adolescents with moderate-to-severe asthma. This review summarizes recent evidence regarding FDA-approved biologics for pediatric asthma—omalizumab, mepolizumab, benralizumab, dupilumab, and tezepelumab—with focus on efficacy, safety, and practical considerations for clinical use.</p> Recent Findings <p> These agents consistently demonstrate reductions in exacerbations, improved lung function, and/or enhanced quality of life. Long-term extension studies have reinforced favorable safety profiles, with low incidence of serious adverse events. Biomarkers such as blood eosinophils, FeNO, and IgE can guide biologic selection, along with presence of coexisting atopic conditions. Ultimately, optimal biologic choice depends on phenotype, biomarker profiles, and patient-specific needs. Pediatric evidence remains limited regarding criteria and strategies for biologic discontinuation.</p> Summary <p> Biologics provide durable benefit and safety in pediatric asthma. Incorporating biomarkers, comorbidities, evolving discontinuation guidance, and shared decision-making with families is essential to optimize therapy and personalize care.</p>