Recent guidelines recommend against the routine use of thrombolytic agents for treatment of venous thromboembolism (VTE) in pediatric patients, suggesting that such therapy be reserved for life- or limb-threatening scenarios. However, evidence supporting such recommendations is weak, and actual practice patterns appear to vary significantly. This workshop will preview the most up-to-date guidelines regarding thrombolysis in pediatric patients; compare different perspectives on controversial aspects of patient management in this area (indication, dosing regimen, and route of administration); and provide a forum for discussion and development of a future randomized clinical trial comparing thrombolysis to conventional anticoagulation alone in the treatment of VTE in children.