Inhalation injury is a leading cause of morbidity and mortality in burn injury in all age groups. The injury may occur alone or in combination with surface bums or other trauma. Exposure to fire conditions produces violent response in the respiratory system. This paper focuses on the incidence and pathophysiology of inhalation injury in children. The nursing care at the scene, in the emergency department, and in the intensive care unit are presented in depth. The ICU aspect is discussed in the form of a nursing standard. Long-term complications are also considered.The nursing care of these children is complex. It can be viewed as both a science and an art.