Diabetic ketoacidosis (DKA) in children and adolescents with diabetes mellitus is a serious acute complication characterized by hyperglycemia, ketosis, and metabolic acidosis. It often occurs due to an absolute insulin deficiency, leading to increased lipolysis and ketogenesis. Symptoms include nausea, vomiting, abdominal pain, and altered mental status. Prompt recognition and treatment are crucial to prevent life-threatening complications such as cerebral edema and organ failure. Treatment involves intravenous fluids to correct dehydration, insulin therapy to lower blood glucose and ketone levels, and electrolyte replacement to restore balance. Close monitoring of blood glucose, electrolytes, and clinical status is essential during treatment. Education for patients and caregivers is vital to recognize early signs of DKA and prevent recurrence through regular insulin administration, adherence to treatment plans, and awareness of triggers like illness or inadequate insulin dosing.