Obstructive sleep apnea (OSA) is a common condition in children and is characterized by repeated episodes of hypoxia, hypercapnia and/or sleep disruption. In children, OSA is usually due to adenotonsillar hypertrophy and the most common treatment is adenotonsillectomy (AT). AT is a highly effective treatment in most cases, but a significant subset of children have residual OSA following AT, especially children who are obese. This review discusses the treatment options for children with OSA, including AT, continuous positive airway pressure therapy, topical corticosteroids, leukotriene receptor antagonists, and dental/orthodontic treatments. AT is the first-line therapy for most children and is likely to remain so, but continuing research into alternatives to surgery is important into the future.