The pattern of injury seen in pediatric hand burns differs from adults because scald burns are most common. Many of these are difficult to assess at initial presentation. In addition, children develop less stiffness in response to immobilization. For these reasons, we have developed a conservative, expectant approach for treating most pediatric hand burns. Meticulous wound care, positioning, splinting, and exercise are required to safely accomplish the goals of rapid healing with minimal loss of function. These regimens are adapted specifically to suit the age of the child and are applied by the burn team. Normal hand function can be obtained in the majority of cases.