Background: The physiology of pediatrics is characterized by a high metabolic rate, limited pulmonary, cardiac and thermoregulatory reserve, and decreased renal function. Multisystem immaturity creates important developmental differences in drug handling and response when compared to the older child or adult. Anesthetic management requires an understanding of the pharmacophysiologic limitations of the child as well as the pathophysiology of coexisting surgical disease. The physiological adaptation to extra uterine life of concern to anesthesiologist involve the respiratory and cardiovascular systems, central and autonomic nervous systems ,metabolism, thermal homeostasis, fluid and electrolyte balance, hemoglobin and the liver. Consequently, children were often under-medicated or not medicated at all for pain. This practice continued until the late 1980s, when changes began to occur in pain management in infants and children as a result of research, consumer demands, and legislation to promote development of drugs for these patients. Substantial evidence now indicates not only that children experience pain but that the pain experience may have long-term adverse consequences. Caudal analgesia is produced by injection of local anaesthetic into the caudal canal. This produces block of the sacral and lumbar nerve roots. It is useful as a supplement to general anaesthesia and for provision of postoperative analgesia. This technique is popular in paediatric patients. Catheter insertion may be performed for continuous caudal block. Caudal block is an easy, simple and safe anesthetic technique. It can be performed in subumbilical surgeries in children and infants, with a high success rate and a low incidence of complications or side effects. It can be concluded that so far, single-shot caudal block with local anesthetic has proved to be an appropriate and effective method for day-case surgeries, especially in pediatric patients.