Children with sleep disordered breathing (SDB) present with a variety of symptoms and signs, so there is controversy making a diagnosis of a pediatric SDB based on snore and/or sleep apnea. It should be considered that a variety of clinical examination, video recording during sleep and a polysomnography as well as local findings, are employed for diagnosing. Adenotonsillectomy is the most common treatment for children with SDB, because most of them show tonsil hypertrophy. Recently, some of articles describe that the improvement of nasal obstruction using fluticasone nasal spray and/or antileukotriene agent is potentially effective for children with mild to moderate SDB. The therapeutic strategy for high risk patients including maxillofacial anomaly, obesity, and others should be considered with respect to each case.