Epilepsy is one of the most common neurological disorders of childhood, and antiepileptic drugs represent the main component of its treatment. The current emphasis in epilepsy treatment is to improve quality of life, not only by suppressing seizure, but also by minimizing the side effects of medications. The last 15 years have been characterized by significant advances in the development of new agents that have helped us to get closer to this goal. Knowledge of the essential properties, key indications and interactions of each antiepileptic drug will help to optimize efficacy and reduce adverse reactions. Age is also a determining factor of the epilepsy phenotype and its treatment. This review addresses the principles of pediatric epilepsy treatment, summarizes the profile of each of the commonly used antiepileptic drugs, and provides a treatment paradigm for particular seizures and epilepsy syndromes of childhood.