S‑ketamine is an N‑methyl‑D‑aspartate receptor (NMDAR) antagonist that combines sedation, analgesia, and anesthesia. It has the characteristics of rapid onset, rapid metabolism and few side effects,and is often used in clinical programmed sedation,perioperative period, to alleviate cancer pain and depression patients. As children's pharmacological and metabolic characteristics and clinical drug experience are different from those of adults, this article reviews the pharmacological effects and clinical application experience of esketamine in pediatric anesthesia, focusing on the metabolism of this drug in children, its effects on respiratory circulation and nervous system, different clinical application scenarios and the occurrence of drug‑related adverse reactions.The aim is to provide theoretical basis and reference for drug selection in the treatment of clinical children.