The biggest cause of non-accidental mortality in children and teens is childhood leukemia. Long-term life expectancies have increased over the past 50 years due to the introduction of new medicines and advancements in postoperative therapy. Nonetheless, among those who have survived leukemia, there is still significant morbidity related to cancer therapy and the prognosis for those whose recurrence is still dismal. The advent of molecular diagnostics, a method that tailors a person's treatment by using knowledge of a disease's genetic and biochemical profiles (as made possible after the next genotyping), has already begun to alter the therapy and diagnostic environment of pediatric cancer. Its application has led to advances in tumor categorization algorithms, a greater understanding of malignant transformation, and the development of physically and molecularly tailored therapy approaches. Precision oncologic oncology is a new method of treating cancer that has lately made significant advancements in reliable clinical practice. Recent developments in precision medicine that may examine the genetic variations of each tumor have high levels of engagement and added new cancer treatment options. The advent of this next-generation sequenced (NGS) has substantially aided our comprehension of pediatric cancer and revealed novel therapeutic options, even though a broad range of molecular techniques can examine malignancies. Compared to adult cancers, pediatric malignancies have a unique genetic makeup and fewer targets that can be targeted. However, the survival rate of patients with leukemia and solid tumors has significantly increased in the pediatric population because of precision oncology. This study examines the state of pediatric personalized oncology today and the clinical situations that can be applied easily. This also includes clinical studies evaluating the diagnostic value of therapeutic applications aligned to genetic abnormalities discovered by tumor screening and explains the latest innovations and different obstacles in personalized medicine for pediatric malignancies