The paper deals with pain in children. In the first part the most relevant physio-pathological aspects and the changing patterns of pain according to age are described. The relevance of the maturation of the central nervous system in the perception of pain and in the evaluation of symptoms is discussed in detail. The age related epidemiology of pain is discussed in the second part of the paper, highlighting the most frequent and clinically relevant pain causes in the different periods of child growth. Finally, the basic golden rules of pain management are discussed from a pragmatical point of view highlighting the importance of adequate drug dosages, association therapy, pre-emptive treatment and non-pharmacological therapeutic strategies.