Orthopedic device infections in children are complicated and diverse, often affecting patients with concomitant conditions such as neuromuscular disorders or solid tumors. As such, diagnosis and management of these infections is personalized, nuanced, and specialized. In this review, we focus on infections related to spinal hardware and prostheses inserted during limb-salvage surgery for bone tumors. Important differences from adults in patient characteristics, epidemiology, and management requirements make it important to understand specific aspects of these infections in pediatric patients to optimize patient care and outcomes.