Infections acquired in hospitals range between 5% and 40% and may lead to complications in over 50% of critically ill patients, especially in the intensive care unit (ICU) settings. The most common causes of healthcare-associated infections (HCAIs) in paediatric ICUs (PICUs) are due to the necessity of frequent contact with healthcare staff, multiple interventions and invasive devices. Ventilator-associated pneumonia, intravascular catheter-associated bloodstream infection, catheter-associated urinary tract infection and surgical site infection are HCAIs and are associated with high morbidity, mortality and increased cost. These can be prevented by the adequate and appropriate application of preventive strategies that can be implemented at the bedside. Basic principles of surveillance strategies, general preventive measures such as standard and isolation precautions, and monitoring of antibiotic use should reduce transmission of HCAIs significantly. Hand hygiene, the use of personal protective equipment (PPE) and aseptic techniques are essential in reducing HCAIs. Specific practical measures for paediatric ICU-related infections should be in place and the monitoring of these activities should be conducted regularly, such as ‘bundle care’ to standardise practice. A well-designed ICU with adequate bed space, isolation rooms, hand hygiene stations, ventilation and filtration systems, waste disposal and equipment storage can help lower the spread of infections.