Corneal transplantation in a pediatric patient population poses special challenges that are not encountered in adults. The surgical procedure is technically more complex because of the small size of the globe, reduced rigidity of the cornea and sclera, and positive vitreous pressure with frequent anterior displacement of the lens-iris diaphragm. Severe inflammatory reaction, secondary glaucoma and immunological graft rejection are also much more likely to occur after surgery. Postoperative visual rehabilitation and amblyopia therapy are crucial but complex in a pediatric patient population. The combination of a dedicated multispeciality transplant team and the education and cooperation of the patient's family are imperative for a successful outcome.