Cancer stage is a core concept in oncology. Assigning the correct stage to a patient’s cancer is the first crucial step toward appropriate management that might ultimately lead to a cure. Vital information regarding cancer spread is recorded through staging workup. Anatomic information about the tumor is only one part of a bigger puzzle. Newer imaging technologies and deeper insights into cancer biology have resulted in a better understanding of the molecular basis and clinical behavior, the recognition of new prognostic biomarkers, and the development of therapeutic strategies. In the following sections, we will review the staging systems currently in use for pediatric cancers. We will also aim to provide the reader with information on some of the more important prognostic indicators for individual cancer types and will endeavor to go one step further to help the decision-making process by at least alluding to the risk stratification of patients, based on the staging and clinical parameters. An effort is also made to provide a surgical perspective, where relevant.