Nutrition is critical for growth and development, which changes throughout the various stages of pediatrics. Patients encounter health compromise throughout acute and chronic illnesses requiring a variety of medical nutrition therapies. Parenteral nutrition (PN), an intravenous therapy comprised of macro- and micronutrients, is a lifesaving therapy administered when gastrointestinal or other organ failure is present. It is also commonly prescribed for patients born prematurely, those with malnutrition, critical illness, or trauma. Timing and duration of PN therapy is dependent on overall nutritional status, nutrient requirements, and short- and long-term clinical consequences. There are clinical considerations for prescribing clinicians as parenteral nutrition is a high-risk medication and requires specialty training, education, and competency. Risks and complications associated with PN include venous access loss, phlebitis, infiltration, infection, nutrient toxicity or deficiency, and long-term organ involvement. Additional training and educational requirements include knowledge of pediatric-specific needs throughout the various phases of growth and development as these differ from adult requirements. Considerations warrant knowledge of birth history and developmental status. Close monitoring and evaluation during therapy is necessary to minimize risks and complications and include surveillance of anthropometric changes, biochemical trends, and nutritional changes.