Paediatric delirium, a complex and often underdiagnosed medical condition, manifests as a transient and fluctuating disturbance in a child's awareness and attention, accompanied by disturbances in cognitive function and perception. This condition, characterized by its acute onset and potential reversibility, poses a significant challenge for healthcare professionals in both diagnosis and management. Rooted in multifactorial etiologies, Paediatric delirium can result from various underlying medical conditions, such as infections, metabolic disturbances, neurologic insults, or exposure to certain medications. Its clinical presentation is diverse, ranging from hyperactive and agitated states to hypoactive and lethargic states, and sometimes a mixed pattern. Identification is further complicated by the fact that Paediatric patients may lack the ability to communicate their symptoms effectively. Early recognition and diagnosis are crucial, as untreated delirium can lead to adverse outcomes, including increased morbidity and mortality. Assessment tools specifically designed for the Paediatric population are essential for accurate diagnosis, emphasizing the importance of collaboration between healthcare providers, families, and multidisciplinary teams. The management of Paediatric delirium requires a tailored approach that addresses underlying causes, provides supportive care, and minimizes the use of potentially exacerbating medications. Moreover, creating a conducive environment that prioritizes the child's comfort, familiar surroundings, and continuity of care is paramount. As research in this field advances, enhancing our understanding of the pathophysiology, risk factors, and optimal interventions, healthcare practitioners can refine their strategies to effectively identify and manage Paediatric delirium, ultimately improving outcomes for this vulnerable patient population.