Sedation of newborns and young children is in ever-increasing demand due to advancements in diagnostic and clinical treatment regimes. Complex procedures demand political and institutional awareness of appropriately staffed and educated healthcare personnel to monitor and safely manage the perianesthetic environment of these fragile patients. Though morbidity and mortality in peri-procedural anesthetic and sedation management of pediatric patients are rare, recent European multicenter trials have demonstrated a higher-than-expected peri-procedural risk of adverse events. The main culprits have been identified as a lack of uniform organizational and educational framework which would otherwise allow for standardization of definitions across medical specialties, increased reporting, and implementation of evidence-based pediatric assessment and treatment protocols. Aiming to enhance safety and quality improvement in pediatric procedures, the European advisory board SafeTots has taken the lead in addressing these challenges through the establishment of a clinical and educational framework.