Unless acute osteomyelitis in children is diagnosed promptly and treated appropriately, it can be a devastating or even fatal disease. This review summarizes the current approach to the treatment of acute osteomyelitis in children. Bacteria may reach bone through direct inoculation from traumatic wounds, by spreading from adjacent tissue affected by cellulitis or septic arthritis, or through hematogenous seeding. In children, an acute bone infection is most often hematogenous in origin.(1) In high-income countries, acute osteomyelitis occurs in about 8 of 100,000 children per year,(2) but it is considerably more common in low-income countries. Boys are affected twice as often as girls.(2),(3) Unless acute osteomyelitis is diagnosed promptly and treated appropriately,(4) it can be a devastating or even fatal disease with a high rate of sequelae, especially in resource-poor countries where patients present ...