Severe burn injuries are the most painful injuries known, and treatment procedures can be extremely aversive as well. Pediatric burn suvivors must often live with permanent disfigurement und physical disabilities. This article presents a review of psychological aspects of severe burn injuries in children and adolescents. The review is based on the scientific literature and own professional experiences. After discussing predisposing factors of burn injuries three phases of medical therapy are defined: 1) acute phase, 2) phase of surgical therapy and 3) phase of rehabilitation. For each of these stages common psychological reactions and potential psychological interventions are presented. Finally psychosocial sequelae and longterm adjustment of pediatric burn injuries are described and implications for the psychological treatment of burned children and adolescents are discussed.