The surgical management of pediatric oncology has expanded in recent years to incorporate minimally invasive surgery and robotic surgery. New frontiers in fluorescence-guided surgery both in Wilms tumor and neuroblastoma, image-guided surgery, and advances in minimally invasive surgery enable the modern pediatric oncology surgeon to push the boundaries of maximal tumor resection with minimal surrounding damage. Post-operative adjunct therapy in the form of brachytherapy, guided radiotherapy, and monoclonal antibodies potentially combined with near-infrared photoimmunotherapy further safeguard those children who were unable to have complete tumor resection. These newer technologies open up technical advancements that can be utilized to further reduce the mortality, reduce existing morbidity, and improve the quality of life for our oncology patients.