Malignant disease acts suppressively on both the innate and the adaptive immune system. Absolute neutrophil count (ANC) less than 500 neutrophils/mL of blood is the main determinate of susceptibility to bacterial and fungal infection. Febrile neutropenia (FN) is an oncologic emergency. Initial evaluation of a patient includes a thorough physical examination, laboratory investigations and microbiological cultures. Empirical antibiotic therapy has to be started immediately. Due to heterogeneity of patients with FN and therapeutic approach, risk factors for stratification into low- and high-risk group have to be implemented. There seems to be a geographical difference in validation of various clinical decision rules and each region has to validate a specific risk model. Bacteria are the most common cause of infection in paediatric oncology patients with prevalent gram-positive infections. Monotherapy with: cefepime, ceftazidime, piperacillin-tazobactam, imipenem and meropenem has been shown to be effective in majority of patients. In persistent FN fungal infection should be suspected, most common fungi being Candida and Aspergillus. Effective antifungals are: amphotericin B deoxycholate, lipid formulations of amphotericin B and echinocandins. The therapy of high risk FN can be ceased when: blood cultures have been negative for 48 hours, patients have been afebrile for 24 hours and there has been a bone marrow recovery. Outpatient management and oral antibiotics are appropriate therapeutic approach for low-risk FN. Ciprofloxacin is the first line therapy. Granulocyte-colony stimulating factor is a valuable addition to the therapy regimen which reduces the number of FN episodes and the length of hospitalization