Although fever in the young child (0–36 months) is a common clinical problem, the evaluation and treatment of febrile children remain controversial. Furthermore, universal vaccination with the heptavalent pneumococcal conjugate vaccine (PCV7) has changed the epidemiology of invasive bacterial disease in young children. This article addresses the approach to febrile neonates (0–28 days old), young infants (1–3 months old), and older infants and toddlers (3–36 months old) in the PCV7 era.