Pediatric laryngopharyngeal reflux (PLPR) refers to the atypical, otorhinolaryngological, and respiratory manifestations of gastroesophageal reflux disease in children. PLPR is believed to be an important inflammatory cofactor in disorders such as subglottic stenosis, asthma, recurrent croup, chronic rhinosinusitis, and middle ear infections. We review the literature, present clinical manifestations, and focus on diagnostic controversies and therapeutic challenges of PLPR in relation to laryngeal manifestations. Current evidence linking reflux to many laryngeal problems is mainly based on animal studies or uncontrolled human studies. Future efforts should concentrate on developing well-designed controlled studies to provide more information on diagnosis and treatment.