Cast immobilization is performed in pediatric patients to support fracture healing, provide post-operative protection, or correct congenital deformities. Pediatric dermatologists will likely encounter the casted patients in their practice. These patients may present with cast-related complications that can arise due to the cast application or removal process, the inner cast environment, direct physical effects of the cast, or other external factors. This article provides a review of the dermatologic complications of cast immobilization, as well as useful recommendations for patients and their families.