Paediatric keloid scars, a unique subset of abnormal wound healing in children, represent a complex and intriguing phenomenon within the realm of dermatology. These hypertrophic scars, characterized by their exaggerated growth beyond the boundaries of the original injury, manifest in Paediatric patients, posing distinct challenges in both diagnosis and management. The etiology of Paediatric keloids is multifactorial, involving genetic predisposition, trauma, inflammation, and aberrant collagen synthesis. These scars often emerge at sites of minor skin trauma or surgical incisions, taking on a raised, firm, and reddish appearance, which can have profound psychosocial implications for affected children. The pathophysiology of Paediatric keloids involves dysregulation of fibroblast activity, leading to excessive collagen deposition and impaired collagen degradation. The scars' unpredictable progression and potential for recurrence make their treatment particularly intricate. A comprehensive approach to Paediatric keloids necessitates a blend of surgical, pharmacological, and non-invasive modalities, aiming to alleviate symptoms, minimize aesthetic impact, and enhance the overall quality of life for Paediatric patients. Advances in laser therapy, corticosteroid injections, and emerging biotechnological interventions hold promise in addressing the unique challenges posed by Paediatric keloids. Beyond the physical aspects, the psychological impact on children coping with these conspicuous scars emphasizes the importance of a holistic and empathetic approach, involving both medical and psychological support. As researchers delve deeper into the molecular mechanisms underpinning Paediatric keloids and clinicians refine treatment strategies, the understanding and management of these scars continue to evolve, offering hope for improved outcomes and enhanced well-being for the youngest members of our population grappling with this intricate dermatological condition.