Multiple sclerosis (MS) is a chronic, demyelinating, immune-mediated disease of the central nervous system. MS can lead to severe neurological disability and demands medical and pharmacological follow-up (both specific and symptomatic) as well as non-pharmacological treatments. MS can affect people of all ages and some patients have the disease onset before they reach the age of 18 years. This creates a limitation in their treatment. Although a very vigorous approach is needed in order to alter the disease course, no drugs have ever been studied in patients below the age of 18 years. When the disease is aggressive and the patient fails to respond to first-line immunomodulatory drugs, the therapeutic approach becomes very limited. Only observational studies are available to support the use of some medications in early-onset MS, and among these, natalizumab comes as an important therapeutic possibility. The present work summarizes data on natalizumab prescribed for patients before they completed 18 years of age, and reports on the efficacy and safety of this drug for this population. There are very few reports in the literature regarding natalizumab for children with MS, but they point towards a good safety profile and highly effective MS control with this therapeutic approach.