Summary: The recent pediatric care increasingly integrates pharmacological treatment with nutritional support, particularly in patients with chronic conditions, growth disorders, or an elevated risk of malnutrition. Enteral nutrition (EN), defined as the delivery of nutrients orally or via feeding tubes, is recommended when oral intake is insufficient or contraindicated. According to ESPGHAN guidelines, EN is indicated in cases of (1) prolonged inadequate energy intake lasting more than 10 days, and (2) insufficient weight gain or weight loss, impaired linear growth, or declining nutritional markers. This paper discusses the clinical indications for EN in pediatric patients as a therapeutic intervention that supports the management of chronic diseases and gastrointestinal dysfunctions. Additional indicators include clinical parameters such as cardiac, pancreatic, and respiratory function. An analysis of EN criteria in children shows that nutritional support should be initiated not only in cases of severe malnutrition but also in moderate growth disturbances, weight loss, or persistent energy deficits. Early identification of relevant risk factors including heart function, pancreatic performance, respiratory capacity, and overall health status, is crucial for timely intervention. Delayed initiation of EN is associated with poorer prognosis, increased risk of complications, and prolonged hospital stays. EN plays a protective role in maintaining intestinal mucosal integrity and supporting immune function. In conclusion, EN should be considered as an integral component of pediatric therapy. Its implementation must be based on individualized health assessment including clinical status and nutritional risk, taking into account both anthropometric and functional indicators to optimize treatment outcomes and recovery.