Background: Melioidosis, caused by ubiquitous Burkholderia pseudomallei is endemic to Malaysia, northern Australia and Southeast Asia. This disease is associated with more than 50% mortality. Often, melioidosis in children is misdiagnosed as leptospirosis, dengue or other tropical infections. This study explores the burden of melioidosis on Malaysian children. Methods and materials: Retrospective data from 2018 Malaysian National Surveillance of Antimicrobial Resistance (NSAR) was retrieved. Pediatric patients of <15 years with culture-confirmed B. pseudomallei were included for further analysis. Next, the epidemiology and antimicrobial susceptibility results were examined. Results: Based on the 2018 NSAR database, 47 B. pseudomallei were isolated from 27 pediatric patients. Of these, 36 isolates were from blood (76.6%), followed by pus/wound (n = 5, 10.6%), tissue (n = 2, 4.3%) and other sites (n = 4, 8.5%). Upon antimicrobial susceptibility testing, all isolates were found to be sensitive to amoxicillin/clavulanic acid, ceftazidime, imipenem and trimethoprim/sulphamethoxazole. In contrast, none of the isolates was sensitive to gentamicin and amikacin. Conclusion: Melioidosis in children often caused a septicaemic form of infection. Albeit its potentially fatal consequences, the aetiologic bacteria remains sensitive to the standard regime of antimicrobial treatment.