Antiarrhythmic drug therapy remains the mainstay of therapy for pediatric supraventricular tachycardia (SVT). In order to appropriately treat pediatric arrhythmias pharmacologically, an understanding of the mechanisms of action, efficacy, adverse effects, and interactions for the different antiarrhythmics is required. This article provides an overview of the pharmacologic treatment options for children with SVT. We review the classification systems, mechanisms of action, pharmacokinetics, and pharmacodynamics of the available antiarrhythmics used in pediatric SVT. We also outline the side effects, drug interactions, and evidence available for the efficacy of these different medications in the pediatric age group.