Background Pediatric wellbeing and health outcomes are among the leading indicators of World Health Organization (WHO). Growing infections and risk of antibiotic resistance have appeared to be one of the main cause if mortality and morbidity in the pediatric population. Cephalosporins, due to their better comparative efficacy and safety, are often first line therapy approach among the pediatric population. Purpose This review is aiming to elaborate the use of cephalosporins in pediatric patients within the Kingdom of Saudi Arabia (KSA). In addition, this review shall also sum up the clinical outcomes after use among the pediatric patients. Results This review highlights the use of clinical efficacy and use of cephalosporins among pediatric population in variety of infections. It was observed that among the included studies the cephalosporins were found effective in combating infections caused by gram-negative bacteria (Escherichia coli, methicillin-susceptible Staphylococcus aureus [MSSA], and nontypeable Haemophilus influenzae [ntHi]), while recognizing their ineffectiveness against methicillin-resistant S. aureus (MRSA) and enterococci. In Saudi health care setting use of Cephalosporins is frequent and this recommendation is based on their broad-spectrum efficacy and clinical safety profile among variety of pediatric infections in different clinical settings. Conclusion This review emphasizes the need to ensure the supervised use of cephalosporins in Saudi health care setting. Implementation of the national clinical guidelines and their synchronization with the global standards shall be a way to ensure long term availability of cephalosporins as 1st line regimen. Promoting rational prescribing methods can reduce the risks of resistance and maintain efficacy in pediatric care.