Autism spectrum disorder (ASD) is a neurodevelopmental disorder that develops during early childhood. It is characterized by social communication deficits, restricted interests, and repetitive behaviors. The various comorbid problems affect the daily functioning and quality of life of patients and their families. In particular, sleep problems, including insomnia, negatively affect the children's social interactions, emotions, and behavior. Melatonin is the most commonly prescribed drug for sleep problems related to ASD during childhood and adolescence, and the link between decreased melatonin concentration and the pathogenesis of sleep disturbances in ASD has been focused on recently. It is essential to evaluate sleep problems in children with ASD and to make appropriate therapeutic interventions. This article reviews the findings on the sleep-melatonin relationship in patients with ASD.