Emergency medical services for children is an all-encompassing, multidisciplinary system that includes parents, primary care providers, prehospital care providers and transport system, community hospital care and tertiary care referral center emergency departments, and pediatric in-patient units including critical care facilities. Assessment of emergency medical care in New Delhi and Chennai in India confirmed the general impression that the organized prehospital care is scanty and that the development of emergency medicine is still in its earliest stages. While the organization of pediatric emergency services at the national level will have to be done by the health administrators, all pediatricians have a role to play in the development of these services within their own institutions. The services to be provided by an Emergency Department should be planned according to the needs of the community that it proposes to serve. Thus, it is important to study the epidemiology of diseases in the area. The size of population is a determinant of the expected patient number. Sociocultural factors, customs and beliefs of the population should also be taken into consideration when planning a pediatric emergency department.