The commonest symptoms that a child may present with to a paediatric orthopaedic surgeon include deformities, gait abnormalities, pain in the limbs, weakness or joint stiffness. Treatment of orthopaedic problems in children will fall into one of three categories; reassurance (for self-limiting disorders), observation (for conditions that may either resolve or progress) or active intervention (for disorders that are likely to remain unchanged or progress if left untreated). Among conditions that need active intervention some need urgent intervention (often as an emergency), some need early intervention while others can be dealt with electively. A clear understanding of the natural history of the various conditions one may encounter is essential in order to decide into which treatment category the child’s condition falls. The conditions that need urgent intervention include acute infections of the bone or joints, malignant bone tumours and slipped capital femoral epiphysis. If these conditions are suspected, prompt referral to a Paediatric Orthopaedic surgeon is essential.