This review discusses the role of interventional procedures in the treatment of chronic pain in children and adolescents. Due to lack of scientific evidence, significant controversy surrounds the utility of invasive techniques for managing pediatric chronic pain states. Interventional procedures are a widely accepted modality for pain management in adults. The use of such techniques in children is supported only by case reports, case series, and very few randomized controlled studies. In addition, the potential for severe complications leaves open a debate on the safety of these invasive procedures, which must be confirmed by more extensive and accurate prospective studies.