Purpose of review <p>This review aims to provide a comprehensive overview of the epidemiology, risk factors, diagnostic strategies, and management of periorbital and orbital cellulitis in children. By synthesizing current evidence, we aim to support the development of an evidence-based clinical guidance to aid in the accurate differentiation and effective treatment of these conditions, reducing complications.</p> Recent findings <p>Recent literature emphasizes the clinical challenge in distinguishing between periorbital and orbital cellulitis due to overlapping symptoms. Imaging modalities such as CT and MRI, alongside targeted laboratory testing and careful clinical evaluation, are critical for accurate diagnosis. Studies also highlight the importance of prompt and appropriate antibiotic therapy tailored to pediatric populations to prevent progression and complications.</p> Summary <p>This review offers pediatric emergency medicine clinicians a practical framework for early and accurate diagnosis of periorbital and orbital cellulitis. We emphasize the importance of timely intervention and appropriate diagnostic tools to improve outcomes. Further research should aim to refine diagnostic criteria and develop personalized treatment strategies for pediatric patients.</p>