Therapeutic plasma exchange (TPE) is performed in a wide range of hematologic, neurologic, rheumatologic, renal and conditions related to organ transplantation. However, indications and outcomes are still mostly based on adult studies and evidence-based data are still lacking for the pediatric population which can also benefit from this procedure in specific circumstances. Research by Guntulu et al. provides a thorough overview of the indications, techniques, complications, and outcomes of 135 pediatric patients treated with TPE. In this large case series sepsis with multiorgan dysfunction syndrome and hematological disorders were the leading indications, citrate was the anticoagulant in most cases and procedure-related complication rate was only 16.3%, and mostly related to vascular access.