The taste and flavour perception of active pharmaceutical ingredients (APIs), particularly bitterness, is a contributing factor to acceptability of pharmaceutical oral dosage forms. This is especially significant for paediatric patients who have an increased sensitivity to aversive tastes compared to adults. Various strategies can be employed to mask the aversive taste of oral formulationsFormulations, as such improving acceptability of paediatric medicines. These strategies can be categorised as either obscuring taste sensors or taste concealing. For obscuring the taste sensors, the taste pathway can be exploited using blocking or competing agents, such as bitter blockers, or sweeteners and flavouring systems which are the most commonly applied taste masking approaches in approved oral paediatric products, the majority being liquids. Taste concealing can be achieved by physical separation of the API and taste receptors via entrapment or encapsulation technologies, for example, film coating, use of lipids, ionic resin complexation, and spray congealing. It is critical to evaluate the effectiveness of the taste masking approach during product development by employing in vivo (e.g. human panels and animal models) and/or in vitro methods (e.g. dissolution and sensor-based approaches). Standardisation of the methods requires further exploration for reproducible and reliable assessments in paediatric medicine development.