Background: Research has widely documented how, even in conditions of extreme poverty, deprivation, or oppression, children are competent and situated actors, capable of actively mobilizing internal, external, or social resources to protect themselves from their environments and safeguard their everyday lives. Yet, the ways in which their agency might support their well-being or instead increase their own vulnerability has remained underexplored. Aims: The present study aims to provide an assessment of all those contributions which, over the past 20 years, have focused on both the positive and negative consequences of children’s actionability, revealing children’s self-destructive acts alongside their self-empowering and protective ones. In the process, it highlights several major theoretical breakthroughs and findings in this area of research. Method: We provide an assessment of peer-reviewed studies that have focused on both positive and negative consequences of children’s actionability, through a qualitative narrative literature review. Results: Of the 168 studies identified from online searches of the literature and the three additional sources gathered through bibliography mining, 76 qualified for full review, with 12 studies included in the final synthesis. Overall, the literature explored the different conditions in which children’s agentic practices expose them to trauma symptoms and to dangerous or self-harmful situations, thereby failing to safeguard their health and overall well-being. Conclusion: The review highlights the need to focus on the dangerous effect of the agentic practices activated by children in terms of their physical and psychological health.