Malignancy-related pain is of similar frequency in children and adolescents as in adults. In children too evaluation of pain intensity, character and location is the basis for individually adapted pain therapy. The choice of medication is determined by the pathophysiological cause and the intensity of the pain. In addition to non-opioid analgesics, tramadol is used for moderate, and morphine for severe, pain. In the case of neuropathic pain, coanalgesics are employed. If oral treatment with morphine is no longer possible, pain pumps for continuous parenteral treatment must be used in children too. Provided the appropriate medical care is possible, parenteral treatment with potent opioids can also be applied at home. In children, every effort must be made to make painful diagnostic and therapeutic measures as painfree as possible.