The RNTCP guidelines for management of pediatric tuberculosis is continuously evolving and this article highlights the 2019 recommendations: • The treatment categories have been simplified to two; new and previously treated. • The definitions of the types of drug resistance have been elucidated. • Daily therapy is recommended as the treatment of choice. • The continuation phase now includes three drugs; isoniazid, rifampicin and ethambutol as isoniazid monoresistance is around 13%. • The antituberculous therapy (ATT) dosing in children is higher as the pharmacokinetic studies have shown that children traditionally achieve lower serum levels than adults. • Empiric category 2 regimen with extension of IP by 2 months has been withdrawn. It is now recommended to investigate for drug resistant TB (DR TB) in such cases. • The indications for steroid usage and dosage in pediatric TB have been clearly defined. The evidence for the routine use of steroids in tuberculomas is unclear as of date. • Pyridoxine supplementation is routinely recommended in children isoniazid is higher for both prophylaxis and treatment.