Pediatric compartment syndrome of the upper extremity is a rare but urgent surgical condition requiring timely diagnosis and intervention to prevent permanent damage. This review synthesizes current evidence on epidemiology, clinical presentation, diagnostic challenges, and management strategies. Despite diagnostic delays and variability in treatment timing including delayed fasciotomy, functional outcomes in children are generally favorable with >80% full functional recovery in most series. However, significant gaps remain in evidence-based guidelines, with the most critical being risk factors, diagnostic thresholds, and optimal wound closure techniques.