<p>Pediatric blepharokeratoconjunctivitis (PBKC) is a chronic inflammatory condition of the ocular surface that affects the eyelids, conjunctiva, and cornea that can lead to corneal scarring and permanent vision loss if untreated. The condition presents with diverse clinical features, necessitating a broad range of therapeutic approaches. Current management strategies include eyelid hygiene practices, topical and systemic antibiotics, and anti-inflammatory agents, often in combination for optimal outcomes. Given the expanding spectrum of medical options and the emergence of new therapeutic avenues, staying current with available treatments can be challenging. This review, based on a PubMed search using the terms pediatric blepharokeratoconjunctivitis, pediatric ocular rosacea, pediatric phlyctenular disease, pediatric phlyctenular keratoconjunctivitis, and pediatric blepharokeratitis, aims to provide ophthalmologists with a comprehensive overview of the current medical strategies. Early and multimodal therapeutic strategies that target multiple facets of eyelid margin and ocular surface inflammation, coupled with timely amblyopia treatment, is required to prevent vision loss due to PBKC.</p>