Corticosteroids are effective and established treatments in various inflammatory and autoimmune disorders. These drugs have a potent anti-inflammatory effect and can be administered systemically or by inhalation, which can be combined with other treatments in the pediatric emergency department. Despite their beneficial effects, however, corticosteroid therapy is associated with many well-known side effects. Many of these side effects can be minimized through the lowest effective dose and duration required for the management of underlying conditions. The objectives of this article are to review a practical guide to corticosteroid therapy in the emergency department.