Pediatric radiofrequency ablation procedures have become commonplace since their introduction to clinical practice 6 years ago. Excellent success rates coupled with low complication rates have allowed these procedures to be offered as first-line therapy to many children. This review focuses on the current indications for radiofrequency ablation in children. These indications are not the same as for adults. They are based on the natural history of various forms of arrhythmias, the risks of the procedure, and the current success rates of the procedures, all of which are dependent upon the age of the patient.