The most common background to hyperpyrexia and convulsions is immaturity of the child’s physiological reactions to infection, so an understanding of the pathophysiology of pyrexia and febrile convulsions in young children enables nurses to take appropriate action. Correct management involves prompt recognition of rising temperature, administration of antipyretic medication, use of other cooling strategies and careful monitoring. Diagnosis of the underlying cause occasionally requires laboratory investigation, if no focus for infection is found, most cases being viral.