In the Netherlands, children are frequently using complementary and alternative medicine (CAM), but data on adverse events are scarce. A three-year registration amongst Dutch pediatricians found 32 cases of adverse events associated with pediatric CAM use. Twenty-two children experienced adverse events that were indirectly related to the CAM treatment, such as delaying or stopping a regular treatment or diagnosis or using an unnecessary (deficient) diet. These indirect effects involved many different therapies. Nine children experienced direct adverse events such as toxicity of an ingested substance or harm due to body manipulation. Direct effects occurred after using herbal medicine, high dose vitamins or supplements, and manual-based manipulation. The authors advise physicians to be aware of potential side-effects of CAM treatment in children and inform parents regarding its use. A list of ten recommendations for parents considering the use of CAM for their children is presented.