Motivational interviewing (MI) is an empirically supported intervention with a large evidentiary base in the adult behavioral medicine and addictions literature. In the last decade, a growing body of research has shown promise for the use of MI in health behavior change settings with pediatric populations. This article provides a description of MI and its differences from other pediatric counseling and medical management approaches. A review of outcome studies of health behavior change interventions using MI with pediatric populations (age 18 and younger) and parents is provided, and implications for clinical development, research, and training are discussed.