Purpose of Review Disaster and mass casualty events are unpredictable and quickly overwhelm response systems. Children are affected by disasters; however, pediatricspecific disaster preparedness is lacking. Preparedness is required at the individual, physician, and hospitals/community levels and constitutes material allocation, education, and communication. Specifically, pediatricians, pediatric subspecialists, and pediatric surgical subspecialists have important roles during a disaster, mass casualty, or pandemic response; thus, integration of both community and subspecialty physicians is important. Disaster response is not limited to planning and response; major efforts in recovery, reunification, community health safety, and follow-up are required. Recent Findings Events have highlighted the need for improved preparation and execution of mass casualty response. There is a need for training in the event of a mass casualty disaster, and pediatric professionals have indicated that they do not feel adequately prepared to care for children during such events. Incorporation of pediatric-specific simulation scenarios can help address this deficiency.Summary Thus, efforts to incorporate pediatric-specific education, disaster simulation, and preparation including a multidisciplinary approach integrating families, physicians, and hospital and community organizations are required.