Background: Paediatric facial fractures are uncommon but clinically important injuries with potential long-term effects on facial growth, dental occlusion, and function. Management differs from adults due to distinct anatomy, fracture patterns, and biological remodelling capacity. Purpose: To review the evidence and core principles guiding assessment and management of paediatric facial fractures, highlighting key differences from adult injury patterns. Methodology: A narrative review of the literature was performed focusing on epidemiology, anatomical considerations, imaging strategies, fracture patterns, and operative and non-operative management. Key recommendations from established trauma and maxillofacial guidelines were synthesised to identify best practice and common clinical pitfalls. Results: Facial fractures occur less frequently in children, with falls representing the predominant mechanism in younger age groups. Paediatric facial bones are thinner and more elastic, resulting in higher rates of greenstick and minimally displaced fractures. Computed tomography with three-dimensional reconstruction remains the imaging modality of choice, although careful clinical correlation is required to guide management. Non-operative treatment is appropriate in many cases due to the high remodelling potential of the paediatric facial skeleton. When surgery is indicated, preservation of growth centres, minimal fixation, and judicious implant selection are essential. Conclusion: Paediatric facial fractures require a tailored approach prioritising growth preservation and long-term functional outcomes. Recognition of the differences between paediatric and adult facial trauma supports safer decision-making and reduces the risk of iatrogenic harm.