This review summarizes the current understanding of post-acute sequelae of COVID-19 (PASC) and post-COVID-19 condition (PCC) in children and adolescents. PASC, also known as Long COVID, encompasses a wide range of unspecific symptoms that persist more than 4 weeks after confirmed or probable SARS-CoV-2 infection. PCC, defined by the WHO, occurs within 3 months of acute COVID-19 and lasts at least 2 months, significantly impacting daily activities. Pediatric PASC is often mild and resolves within a few months, but symptoms can last over a year and cause significant disability. Common symptoms include fatigue, exertional intolerance, and anxiety. Some patients present with postural tachycardia syndrome (PoTS) or myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). No specific diagnostic markers exist, making differential diagnosis challenging. Treatment includes self-management strategies and palliative approaches, including non-pharmaceutical and pharmaceutical interventions. The review highlights the need for interdisciplinary, individualized, and stepped approaches to manage PASC and PCC, emphasizing the importance of adapting healthcare structures to meet the needs of affected children and adolescents.This review summarizes the current understanding of post-acute sequelae of COVID-19 (PASC) and post-COVID-19 condition (PCC) in children and adolescents. PASC, also known as Long COVID, encompasses a wide range of unspecific symptoms that persist more than 4 weeks after confirmed or probable SARS-CoV-2 infection. PCC, defined by the WHO, occurs within 3 months of acute COVID-19 and lasts at least 2 months, significantly impacting daily activities. Pediatric PASC is often mild and resolves within a few months, but symptoms can last over a year and cause significant disability. Common symptoms include fatigue, exertional intolerance, and anxiety. Some patients present with postural tachycardia syndrome (PoTS) or myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). No specific diagnostic markers exist, making differential diagnosis challenging. Treatment includes self-management strategies and palliative approaches, including non-pharmaceutical and pharmaceutical interventions. The review highlights the need for interdisciplinary, individualized, and stepped approaches to manage PASC and PCC, emphasizing the importance of adapting healthcare structures to meet the needs of affected children and adolescents.