Acute gastroenteritis is a common problem in children and refers to infections of the gastrointestinal tract caused by viral, bacterial or parasitic pathogens. Most cases are not serious and self-limiting. However, severe complications and a high mortality rate may be associated, with diarrhoea being responsible for up to 2.5 million deaths worldwide in young children each year. Diarrhoea may also contribute to serious morbidity where acute cases become persistent with a significant impact on nutritional status. Various risk factors can be identified, such as malnutrition, young age, immune compromised and increased exposure to pathogens due to poor hygiene and sanitation. Clinical evaluation includes a thorough assessment of the features and degree of dehydration as well as of comorbid conditions. The IMCI guidelines provide valuable protocols for prompt management of acute diarrhoea and dehydration in children, while supplementary zinc, adequate feeding practices and appropriate antibiotic treatment in selected cases contribute further to reduce the duration, severity and mortality of acute diarrhoeal disease in childhood.