Purpose <p>Supracondylar humerus fractures are the commonest elbow injuries in children. In spite of recent advances, there is a dilemma on various aspects of treatment while approaching a child with supracondylar humerus fracture.</p> Methods <p>This article is a narrative review of the available literature on the presentation and management of supracondylar humerus fracture in children to provide an overview on the choice of conservative vs surgical treatment, the correct timing of surgery, ideal pin configuration for the particular fracture pattern, indications for open reduction and management in the presence of associated neurovascular injury.</p> Conclusions <p>The goal of treatment in supracondylar humerus fractures is to achieve union without causing any deformity or complications. A thorough knowledge of the pathoanatomy, classification, clinicoradiological assessment of the fracture and timely management are essential to achieve the desired goal. Closed reduction and percutaneous pinning is the most common form of treatment. Various modifications of the technique are recommended in certain cases. Proper classification of the fracture type is essential to decide the correct pin configuration. It is essential to identify associated vascular injury and manage it promptly to avoid any permanent morbidity. Majority of the nerve injuries are in the form of neuropraxia that heal spontaneously.</p>