Preseptal and orbital cellulitis occur more commonly in children than adults. The history and physical examination are crucial in distinguishing between preseptal and orbital cellulitis. The orbital septum delineates the anterior eyelid soft tissues from the orbital soft tissue. Infections anterior to the orbital septum are classified as preseptal cellulitis and those posterior to the orbital septum are termed orbital cellulitis. Recognition of orbital involvement is important not only because of the threatened vision loss associated with orbital cellulitis but also because of the potential for central nervous system complications including cavernous sinus thrombosis, meningitis, and death. Care for these patients is often shared between the pediatrician, ophthalmologist, and otolaryngologist. We review recent developments in the diagnosis, microbiology, and management of patients with preseptal and orbital cellulitis.