This chapter discusses the current knowledge on nailfold capillaroscopic findings in children with an age below 18 years, including healthy ones and those with connective tissue diseases (CTD). Although, studies of nailfold capillaroscopy (NFC) in children are less numerous than those in adults, NFC is a key tool in differentiating primary and secondary Raynaud’s phenomenon (RP) and allowing earlier diagnosis of CTDs in children as it does in adults. It also has a role in disease monitoring of juvenile CTDs, which is best described in juvenile dermatomyositis (JDM) with a growing interest in childhood onset SLE, juvenile systemic sclerosis (jSSc) and mixed/overlap CTD. NFC is therefore an important tool for all specialists caring for children with potential or diagnosed CTDs. We summarise the current paediatric literature on NFC to inform specialists in the role and interpretation of NFC findings in children.