<p>The 2025 International Liaison Committee on Resuscitation (ILCOR) Pediatric Life Support (PLS) update introduces ten significant changes aimed at improving the timeliness, quality, and physiologic precision of pediatric resuscitation. Based on the review of 39 PICOST questions, the update highlights early cardiopulmonary resuscitation (CPR) for bradycardia with poor perfusion, renewed emphasis on pediatric early warning systems (PEWS) for early deterioration detection, and reaffirmation of bag-mask ventilation as the preferred initial airway technique. Both ABC and CAB sequences are now acceptable for initiating CPR. Defibrillation guidance continues to recommend an initial 2–4&#xa0;J/kg/dose and now favours anteroposterior pad placement. The traditional 10-second pulse check rule has been withdrawn in favour of immediate CPR when signs of life are uncertain. Epinephrine timing has become rhythm-specific, supporting early use in non-shockable rhythms and delayed administration after the second shock for shockable rhythms. New physiologic targets—including diastolic blood pressure thresholds and ETCO₂ &gt;20 mmHg—promote hemodynamic-guided CPR, while post-arrest care incorporates systolic blood pressure goals and a multimodal approach to neuro-prognostication. Some earlier recommendations have been removed or revised, reflecting updated evidence. Together, these changes mark a shift toward clearer, physiology-based, goal-directed resuscitation practices designed to improve survival and neurologic outcomes.</p>