Post-burn pruritus is a common and challenging complication for patients suffering burn injuries, affecting up to 93% of patients. It has potentially debilitating effects on rehabilitation and quality of life and remains especially difficult for clinicians to treat due to its multifactorial pathophysiology and limited response to treatments. To date there is a lack of consensus guidelines on the systematic management of post-burn pruritus, in part due to the difficulty in objective measurement of its severity and response to treatment, especially in the paediatric population. This review aims to summarise the current understanding of the pathophysiology behind post-burn pruritus, and compare the effectiveness of current treatment options. These include pharmacological agents (antihistamines, gabapentinoids, topical capsaicin and serotonin receptor antagonists) and non-pharmacological strategies (compression garments, silicone sheeting, laser therapy and massage). The presentation will empower burns clinicians at all experience levels to employ a multimodal treatment approach to this complex and refractory clinical problem.