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Caring for the limb deficient child may be initially daunting, but typically is quite rewarding for the orthopaedist and medical team. This article serves as a primer to those surgeons who are in training or infrequently treating this population. Insights are provided throughout to aid the orthopaedist in maneuvering the many facets of pediatric prosthetic care, including answers to questions common asked by surgeons or families. Involvement of the prosthetist early and then throughout the child’s care is crucial in achieving optimal outcomes in prosthetic design, fit, function and utilization. Although a multi-disciplinary team may not be available at all institutions, it is important to aim for this approach whenever possible. With the right balance of surgical, functional, prosthetic and therapeutic considerations, children with limb differences typically are able to keep up with their peers and participate in a variety of activities, such as school, sports and music.