In general, external fixation can be used in pediatric patients just as it would be used in adult patients. The most common clinical scenarios would be deformity correction, reconstruction following trauma, and contracture correction. However, several differences make the use of external fixation in children unique, including the physical presence of the physis, the potential for growth, and the smaller body size. Although these factors create a perception that the application of external fixation can be difficult to perform in a child, this is not necessarily true. This article outlines philosophies and techniques to help make external fixation of a pediatric patient a positive experience for both the surgeon and the patient.