The systemic vasculitides are comparatively rare but important disorders of childhood. Apart from Henoch-Schönlein purpura, which is the commonest example in paediatric practice, Kawasaki disease is most often encountered. Polyarteritis and Wagener's granulomatosis have a lower incidence but are associated with a high morbidity and mortality. Newer investigative procedures and therapeutic approaches have led to more accurate diagnoses and improved outcome but further advances await a better understanding of the vasculitides: polyarteritis; Kawasaki disease; Wagener's granulomatosis; and ANCA in childhood.