Paediatric Granulomatous Disorders encompass a heterogeneous group of rare and complex conditions characterized by the formation of granulomas, which are abnormal inflammatory nodules, in various tissues of the body in children. These disorders result from dysregulated immune responses that lead to the accumulation of immune cells, particularly macrophages, forming granulomas that can affect multiple organs, including the lungs, skin, eyes, and lymph nodes. The pathogenesis of these disorders is often rooted in genetic mutations, with several identified genes implicated in the abnormal immune response. One notable example is Blau syndrome, associated with mutations in the NOD2 gene, which plays a crucial role in immune regulation. Another well-known disorder is Chronic Granulomatous Disease (CGD), an inherited immunodeficiency characterized by impaired phagocyte function, leading to recurrent bacterial and fungal infections. The clinical presentation of Paediatric granulomatous disorders is diverse, ranging from asymptomatic cases to severe, life-threatening complications. Diagnosis involves a multidisciplinary approach, including clinical evaluation, imaging studies, genetic testing, and, in some cases, biopsy of affected tissues. Treatment strategies aim to manage symptoms, control inflammation, and prevent complications. Corticosteroids and immunosuppressive agents are commonly used, although emerging targeted therapies and biologics show promise in specific cases. The long-term outlook for affected children varies, and ongoing research is crucial to unravel the intricacies of these disorders, paving the way for more effective and targeted therapeutic interventions, ultimately improving the quality of life for Paediatric patients grappling with these challenging conditions.