This paper describes important psychological and psychosocial considerations in pediatric transplantation that can be valuable for all pediatric health care providers in the transplant setting. A developmental perspective is necessary in the consideration of these implications throughout the transplant process. Each age range (infancy, toddler and preschool, school age, and adolescence) is discussed with its normal associated developmental milestones as well as the impact transplantation can have on these milestones. Appropriate evaluation and referrals are also explained in the context of the pediatric transplant setting.