Infective endocarditis (IE) is an infection originating from the endocardium and/or heart valves. Although the overall incidence of IE in children is relatively low, it carries a high mortality once happened. Timely identification and prompt treatment are crucial to avert adverse clinical outcomes. In recent issue, Prof. Cao et al. reported a case of IE caused by methicillin-resistant Staphylococcus aureus after congenital heart disease operation (J Clin Pediatr Vol.42 No.8 Aug. 2024), which underscored the complexities and challenges involved in diagnosing and managing IE in pediatric patients. Herein, we will further discuss the clinical features, antibiotic options, and optimal timing of surgical intervention for pediatric IE, aiming to enhance clinicians' understanding of this condition.