Caring for children affected by cancer presents one of the most challenging situations for both family members and healthcare workers. Treating children is highly complicated compared to adult patients because they do not understand the severity of the ailment, inability to make educated judgments, and tendency to experience pain during procedures and treatment, and require significant emotional support. Furthermore, cancer treatment is often prolonged and expensive, affecting families both psychologically and financially. In such circumstances, healthcare providers bear the responsibility to provide optimal treatment while also addressing the stress and suffering of both the patient and the caregivers. Pediatric oncology healthcare workers are often exposed to a range of medical and non-medical ethical dilemmas, including breaking bad news, obtaining assent and informed consent, managing financial toxicity, addressing oncofertility concerns, managing treatment-induced long-term side effects, and handling end-of-life issues, all of can be highly challenging. Moreover, the resolution of these processes can be complex, often leaving healthcare workers with more questions than answers. There are very few articles addressing the moral issues faced by healthcare workers treating children affected by cancer in India. This review, based on 12 years of work by the Bioethics Consortium, addresses the most commonly encountered clinical aspects in Indian clinics and aims to contribute to the development of teaching and training of healthcare students and professionals.