ObjectiveAminoglycoside antibiotics remain essential for treating serious neonatal and pediatric infections, yet carry a well-documented risk of permanent auditory and vestibular toxicity. This review examines the pharmacological mechanisms of ototoxicity in pediatric populations, identifies those at highest risk, and assesses current prevention, monitoring, and management strategies.MethodsPubMed, EMBASE, Cochrane Library, Web of Science, and CINAHL were searched for relevant literature from 20