Purpose of Review <p>To provide an update and new insights into the management of pediatric patients with chronic urticaria.</p> Recent Findings <p>Chronic urticaria in children may be more prevalent than previously thought, with a high resolution rate within two years. Patient-reported outcome measures (PROMs) are effective tools for assessing disease severity and control in pediatric populations. Children with chronic urticaria generally respond better to H1-antihistamines compared to adults. For patients refractory to antihistamines, omalizumab has shown excellent efficacy. Additionally, dupilumab has emerged as a potential treatment option, as it has been approved for chronic spontaneous urticaria in some countries.</p> Summary <p>Managing chronic urticaria in children remains a diagnostic and therapeutic challenge. However, advancements in understanding disease mechanisms, the validation of tools to assess disease activity and control, the development of reliable biomarkers, and the availability of novel therapies offer significant promise. These developments will enable more effective treatment and improved outcomes for pediatric patients.</p>