Drowning is the third leading cause of injury death in the pediatric population worldwide, with incidence peaking among those aged 1–4 years and again in adolescence.The purpose of this commentary is to review the basic pathophysiology of drowninginjury and factors that affect the outcome, such as submersion and hypothermia. We also discuss principles of prehospital and in-hospital management, comprising resuscitation and stabilization, administration of oxygen and intravenous liquids, and central reheating.Even though the mortality rate has decreased in recent years, further investments and safety measures are needed to prevent child drowning deaths.Supplementary InformationThe online version contains supplementary material available at 10.1186/s13052-023-01464-1.