The purpose of perioperative fluid management in children is to maintain the homeostasis of volume status, electrolyte levels, and endocrine system in the perioperative period. Although hypotonic solution containing glucose has traditionally been used for pediatric maintenance fluid, recent studies have shown that isotonic balanced crystalloid solution lowers the risk of hyponatremia and metabolic acidosis perioperatively. Isotonic balanced solutions have been found to exhibit more physiological and safer characteristics for perioperative fluid maintenance and replacement. Adding 1-2.5% glucose to maintenance fluid can help prevent children from developing hypoglycemia, as well as lipid mobilization, ketosis, and hyperglycemia. The fasting time should be as short as possible without compromising the safety of children, and it has recently been recommended to reduce clear fluid fasting time to 1hr. The ongoing loss of fluid and blood, as well as free water retention induced by anti-diuretic hormone, are unique characteristics that must be considered in postoperative fluid management. Reduced infusion rate of isotonic balanced solution may be required to avoid dilutional hyponatremia during the postoperative period. In summary, Perioperative fluid management in pediatric patients requires careful attention due to their limited reserve capacity. Isotonic balanced solutions appear to be the safest and most beneficial choice for most pediatric patients, considering their physiology and safety aspects.