The number of retinal detachments in children is rarely compared to the number of retinal detachments in adults; only 3 - 7% occur in children. The main predisposing factors are trauma, myopia, hereditary vitreoretinopathies, retinopathy of prematurity, malformations and Coats' disease. The most frequent paediatric retinal detachments are trauma-associated and vitreoretinopathies are the most common cause of inherited retinal detachment. Disease-specific surgical treatments are discussed. Episcleral buckling surgery should be the preferred method in any case of clear lens, especially for treatment of oradialysis and well-defined localization of peripherally retinal tears. In those suffering from vitreoretinopathy, primary vitrectomy is necessary. The intravitreal use of VEGF-inhibitors to treat vasoproliferative retinopathy in children is a new and effective tool, but we need further results about safety and side-effects in young patients. The functional and anatomical outcomes of retinal detachment in children are less successful than in adults. Further surgical innovations and etiology-specific treatment strategies are required to improve the outcome in this group.