Omalizumab is a humanized monoclonal antibody used in the treatment of moderate to severe allergic asthma in children over 12 years and adults. There are many adult studies that have shown it to be a safe drug. The adult clinical trials show improvement in clinical outcomes for patients on omalizumab but reports on its real-life use in children are few. Additional studies for the use of omalizumab in pediatric population are needed. The aim of this paper is to review the limited pediatric literature and compare with a retrospective chart review done for pediatric patients taking omalizumab at a tertiary pulmonary clinic with moderate to severe allergic asthma. A review of the recent pediatric studies was compared with a retrospective chart review on all patients prescribed Xolair (omalizumab) (n=13) between 2003 and 2010. The recent pediatric studies showed a reduction in prednisolone use, improvement of Asthma Control Test, improvement of Asthma Quality of Life Questionnaire, and clinically significant decrease in asthma exacerbations. In the retrospective review there was a clinically significant decrease in the number of hospital days and a trend in decrease of emergency room visits. There was no clinically significant difference in lung function. Adverse reactions were noted. The recent pediatric studies showed omalizumab improved overall health of children with asthma but more pediatric studies are needed.