Pediatric cancer, though rare compared with adult malignancy, remains a significant cause of morbidity and mortality, with approximately 15,000 new diagnoses and over 1,500 deaths annually in the United States. Advances in multimodal therapy and cooperative group clinical trials have improved overall survival rates to over 80% in developed nations. Pediatric interventional oncology, a subset of pediatric interventional radiology (IR), has expanded beyond its role in biopsy and vascular access to include tumor-targeted and supportive care interventions. However, challenges in the field remain, including less pediatric-specific data and limited access to pediatric-trained interventional radiologists. Multidisciplinary collaboration is important for the integration of pediatric interventional oncology as a key component of pediatric cancer treatment.