Myocarditis is an uncommon but significant disease in children. Diagnosis requires a high index of suspicion and understanding of the clinical presentation of this disease. The understanding of the mechanisms of disease-host immune response and host response has improved, but is not completely known. Therapy remains mainly supportive, while the use of immunotherapy in children is still controversial. The majority of children will improve; however, a substantial portion of children will die or develop persistent dilated cardiomyopathy leading to necessary heart transplantation.