Although the vast majority of viral infections are not definitively diagnosed, there are many febrile exanthems of childhood that are identifiable by the association of their prominent features. Early classifications of febrile exanthems of childhood included measles, scarlet fever, rubella, erythema infectiosum, and roseola. Other exanthems include hand, foot, and mouth disease caused by coxsackievirus and chickenpox caused by varicella. Each illness has a distinctive rash and typical febrile course. Although most of these childhood illnesses result in self-limiting and benign outcomes, all can cause significant discomfort and parental concern. More importantly, some infections may lead to significant illness requiring extensive evaluation and hospitalization. Other infections may have sequelae with significant morbidity such as soft tissue infection following varicella infection or congenital rubella infection. Learning the clinical presentations will be valuable in developing differential diagnoses, planning laboratory evaluations, and predicting the clinical course of these childhood febrile exanthems.