Pediatric spiritual care in complex medical contexts requires the ability to shift perspectives rapidly. Care with a child must be age appropriate, while care to the family is also grounded in sociocultural perspectives. Furthermore, the care must uphold the commitment to support the interdisciplinary staff that cares for children. A Practical Theology of Pediatric Chaplaincy empowers chaplains and religious leaders to stand in the liminal spaces to provide spiritual care to sick and dying children through privileging open and relational practical theologies, family systems theory, and interdisciplinary collaboration.