Immunosuppressed children are particularly at risk of vaccine preventable diseases, however, vaccine coverage in this population remains too low. This is explained by a fear of possible adverse effects of vaccines under immunosuppression, but also lack of data and clear recommendations in particular regarding vaccination with live vaccines in this population. In this review, the latest literature and various recommendations on vaccination in immunosuppressed children are discussed in detail, with the aim to give practical guidelines on vaccination to specialists caring for children suffering from different dysimmune disorders and treated with various immunosuppressive regimens.