Coeliac disease (CD) is common in children with an estimated prevalence of approximately 1:100. The clinical presentation has altered over the last decade, with most children manifesting non-specific or mild symptoms. The accuracy of serological testing has improved dramatically with targeted assessment of children with conditions known to be associated with CD leading to the detection of asymptomatic cases. The diagnosis of CD still requires upper gastrointestinal endoscopy and small bowel biopsy, and management requires a life-long gluten-free diet to avoid long-term complications.