A critical responsibility of the clinical microbiology laboratory serving clinicians who care for infected children is accurate and timely detection of bacteremia. Blood culture protocols which are suitable for processing adult specimens are not necessarily the first choice for processing pediatric specimens. In this review, the following aspects of detection of bacteremia in children are covered: obtaining blood culture specimens from children, including skin disinfection, specimen volume and timing of specimen collection; the array of blood culture methods available, focusing upon conventional, radiometric, infrared spectroscopic and manometric broth cultures, as well as biphasic agar/broth and lysis direct plating techniques: the strengths and weaknesses of the various methods; and recommendations to laboratories for selection of a blood culture method based upon the laboratory's staffing level.