This article discusses the perioperative management of adrenal insufficiency in pediatric patients. Adrenal crises, which can be life-threatening, can occur in patients with adrenal insufficiency during periods of physiological stress. The primary management strategy is stress dosing of hydrocortisone, often combined with dextrose-containing intravenous fluids. The article presents a retrospective analysis of data on perioperative hydrocortisone dosing in pediatric patients with adrenal insufficiency, highlighting significant variability in dosing and a low incidence of adverse events. The findings emphasize the importance of institutional guideline development, education, and further research in this field to improve perioperative management of adrenal insufficiency in children. [Extracted from the article]