Purpose of Review <p>Severe cutaneous adverse reactions (SCAR) are rare, delayed drug hypersensitivity reactions, that can be potentially life-threatening and are associated with high morbidity. There is limited literature specifically addressing paediatric SCARs, mainly consisting of case reports and small retrospective reviews. This review summarizes current knowledge on the epidemiology, causative drugs, clinical features, differential diagnosis and management of SCARs in children and adolescents.</p> Recent Findings <p>Recent studies are highlighting the differences between SCARs in adults and children, especially regarding epidemiology, causative drugs, clinical presentation and long-term sequelae. Although the pathophysiology is not completely understood, emerging research suggests possible biomarkers for diagnosis and severity assessment. Considering SCARs management, novel targeted therapies have been studied in adults but are often extrapolated for paediatric use.</p> Summary <p>SCARs in paediatric age represent a challenge in their recognition, diagnosis and management. Prompt withdrawal of causative drugs, institution of supportive care, early therapeutic initiation and a multidisciplinary approach can lead to better outcomes. Referral to Allergy and Immunology assessment is mandatory to confirm the culprit drug and potential cross-reactivities. Further research addressing specifically paediatric age is needed to establish clinical practice guidelines for children and adolescents.</p>