The changing patterns of care for children with chronic diseases has been marked primarily by the overall improvement in prognosis due to technical progress. We have evolved in many ways. Definitions and epidemiology have changed with the emergence of new diseases and especially the overall increase in the number of children with chronic disease. The situations have diversified especially in relation to the means of revelation. We have individualized significant steps such as the announcement, evolutionary phases, and transitions. Cure is possible in children. The care modalities must answer the question “What do we want ?” : further technical progress, associate care and support, involve families, integrate soma-psychic aspects... Two developments in care seem remarkable : interdisciplinarity and therapeutic patient education.