Recent advances in the field of flexible fiberoptic technology have facilitated the diagnosis and treatment of a wide variety of gastrointestinal diseases in children. As a result, pediatric patients are becoming more common in the endoscopy suite. Although many technical aspects of colonoscopy are the same whether applied to adult or pediatric patients, subtle differences do exist. Recognition of these differences will lead to a safer and more successful procedure for the pediatric patient. This article addresses the application of colonoscopy to pediatric populations based on review of current literature and personal experience of the author.