Human papillomavirus infections in children, particularly when occurring as condylomata acuminata, present a difficult and often puzzling problem. The possibility that the lesions were acquired through sexual contact mandates a careful and thorough evaluation. Even then, the source of the infection may be elusive because of a long latency between inoculation and the development of lesions, the secretive milieu of childhood sexual abuse, and lack of data about modes of transmission. New molecular techniques of HPV DNA detection and typing have not proven to be helpful in determining the source of the infection but may assist in identifying children who are at risk for the development of carcinoma. Various treatment modalities have been attempted with a significant percentage of recurrences. Many unanswered questions remain regarding the biology and epidemiology of HPV in children and adults. Clinical and basic science research specifically designed to address the concerns of the pediatric age group is urgently needed.