Open fracture and firearm wounds in children are rare than adults. The most common reasons of the open fractures in children are road traffic accidents or falling from height. They have relatively high incidence in boys. Open fractures of tibia and radius-ulna are more common than other bones. Due to high blood supply and thick periosteum, the fractures of children heal faster than adults. Also, surgical site infections in children are less than adults. All open fractures should undergo irrigation and debridement within 24 hours of the injury. Type I open fractures are treated with irrigation-debridement and cast applied in emergency room. Type II and III open fractures should be treated in the operating room. Traumatized patient must be given a dose of intravenous antibiotics as soon as possible in the hospital. All children should receive intravenous antibiotic therapy for 24 to 48 hours after irrigation and debridement.