This review describes the microbiology, diagnosis and management of cervical lymphadenitis (CL) in children. The most common bacterial organisms causing acute unilateral infection associated with facial trauma or impetigo are Staphylococcus aureus and group A β-hemolytic streptococci. Other causes include Bartonella henselae, Francisella tularensis, Pasteurella multocida, Yersinia pestis, Actinobacillus actinomycetemcomitans, Burkholderia gladioli, Mycobacterium tuberculosis and nontuberculous mycobacteria. Other rare aerobic pathogens are Streptococcus pneumoniae and gram-negative rods. Studies that utilized methodologies that were adequate for the recovery of anaerobes demonstrated the importance of these organisms in CL. The predominant anaerobes were Peptostreptococcus spp., gram-negative bacilli and Fusobacterium spp. The most common viruses are Epstein-Barr virus, cytomegalovirus, herpes simplex virus, adenovirus, enterovirus, roseola, rubella and the human immunodeficiency virus. Therapy includes administration of antibiotics effective against the causative pathogen(s). Proper selection of therapy can be guided by culture of the lesion. Surgical drainage may be necessary in case of suppuration.