Bacteria have been implicated in the pathogenesis and progression of pulpal and periapical diseases. The primary aim of endodontic treatment is to remove as many bacteria as possible from the root canal system and then create an environment in which remaining microorganisms cannot survive. Antibiotics form an important part of routine endodontic practice. They have been used routinely in children as an adjunct in a number of ways: systemically, locally and prophylactically. Systemic antibiotics have been used in clinical practice far more than is necessary. As topical agents they have been used as an intra-canal pulpotomy/pulpectomy medicament and root canal irrigant. Although their inadvertent use raises concern, the most important decision in antibiotic therapy should not be about which antibiotic should be used but whether antibiotics should be used at all. This paper reviews the role of antibiotics in paediatric endodontics by highlighting their effects and concerns in detail. Keywords: antibiotics, drugs, infected tooth, irreversible pulpitis, prophylactic, root canal treatment, systemic, topical