This chapter provides a comprehensive examination of Long COVID fatigue in pediatric populations, focusing on its prevalence, characteristics, underlying mechanisms, and management strategies. The text reviews current epidemiological data, which shows prevalence rates of persistent symptoms ranging from 4% to 66% in children and adolescents, with fatigue being one of the most commonly reported symptoms. The chapter explores various potential mechanisms underlying pediatric Long COVID fatigue, including immune dysregulation, autonomic dysfunction, mitochondrial impairment, and psychosocial factors. It details management approaches, emphasizing the importance of multidisciplinary care through strategies such as pacing, energy conservation, cognitive-behavioral therapy, and appropriate physical activity management. The discussion includes specific considerations for pediatric patients, particularly regarding the impact on educational participation and social development. The chapter concludes by identifying critical areas for future research, including the need for large-scale epidemiological studies, mechanistic investigations, intervention trials, and qualitative research to better understand and address Long COVID fatigue in this vulnerable population.