Chest pain is a very common symptom in children and adolescents. Musculoskeletal pain is the most common cause of their chest pain and the cardiac cause is very rare in children and adolescents. However, evaluation is required for every patient with chest pain, especially for those with the history and physical examination of importance. For common chest pains, reassurance and education of the patient and the parents about their benign nature is sufficient. On the other hand, chest pain on exertion, symptoms of myocardial ischemia, or abnormal cardiac examinations are more likely to be of cardiac origin, and prompt referral to a pediatric cardiologist is recommended.