How are children and young people made sense of and acted upon in the politics of global health? How do children and young people interpret, resist and engage with the discourses, policies and sites populated by established, institutionalized global health actors? This contribution takes stock and critically interrogates the state of research on childhood and youth in the politics of global health. It contrasts the dearth of academic engagement with the place of young people in global (health) governance with the manifold forms of institutionalized participation that has proliferated in international institutions in recent years. We perform a systematic review of global health scholarship across pertinent academic outlets, epistemological and disciplinary divides and find that the political agency and representation of children and youth in global health politics has not been systematically, or comprehensively researched. Thereafter, we map youth representation in global health empirically, pointing to its varied institutionalized forms and the involvement of both public and private, adult and youth-led organizations. Our chapter highlights the contestation surrounding both the notions of ‘child’ and ‘youth’ and the indeterminate boundaries between these two identities. We also show that despite strong normative commitments to making children and youth heard, the emerging institutional ecology surrounding young people’s engagement in global health is marked by a strong presence of youth while children are largely at the margins. At the same time, even youth representation in global health is characterized by homogenous depoliticized discourses that often do not perceive of young people as competent political actors in the present. The concluding section of our chapter proposes new avenues for research into the political representation of children and young people in this global policy field.