Background <p>Over the past two decades, Pediatric Interventional Radiology (PIR) has matured from the adaptation of adult techniques into a distinct subspecialty that provides minimally invasive, image-guided interventions specifically tailored to this vulnerable population. These procedures accommodate several unique anatomical considerations, physiological responses, and disease presentations seen in pediatrics from infants to adolescents.</p> Methods <p>A literature review was conducted to identify articles published from January 1, 2010, to June 1, 2025, that included the terms “pediatric” and “interventional radiology” in their titles or abstracts. Twenty five studies were selected and synthesized, along with relevant historical data, regarding workforce development and device progression.</p> Results <p>The availability of PIR services in children’s hospitals increased by over 130%, alongside a threefold increase in fellowship-trained pediatric interventional radiologists and a fourfold increase in membership within the Society for Pediatric Interventional Radiology. During this time, specialized pediatric devices, such as specific catheters, micro-wires, and stents, are now used to appropriately treat approximately 25% of common procedural needs, thereby limiting the need for the improvised use of adult equipment. Technical procedural completion rates consistently exceed 90% for central venous catheter placements, gastrostomy insertions, abscess drainages, vascular malformation sclerotherapy, intussusception reductions, and trauma-related embolizations. Comparative studies even demonstrate that PIR’s minimally invasive nature results in shorter hospital stays and lower complication rates than equivalent surgical treatments. Advancements in radiation-sparing techniques, including adherence to the ALARA principles, routine ultrasound-first imaging, and tailored sedation protocols, have collectively reduced radiation exposure by half while maintaining major complication rates below 2%. Furthermore, family satisfaction rates remain high, indicating that both parents and physicians recognize the advantages of minimal scarring, rapid recovery, and comprehensive child-life support. Even so, significant gaps persist, such as limited pediatric device availability, variability in radiation safety metrics, and a scarcity of longitudinal outcomes data.</p> Conclusions <p>PIR now plays a critical role in pediatric healthcare and infrastructure, providing precise yet efficient, low-morbidity alternatives to traditional surgical interventions for congenital, malignant, and traumatic conditions. The field will continue to progress, and may require focused device innovation, standardized radiation safety practices, and multicenter longitudinal registries to further enhance patient outcomes and family-centered care.</p>