Abstract: As a special medication-using population, children exhibit significantly higher complexity and risks in drug therapy compared to adults due to their unique physiological and pharmacokinetic characteristics. Traditional pharmacy service models struggle to meet the individualized and safety requirements of pediatric medication. In recent years, driven by national policies such as “Internet Plus Healthcare” and artificial intelligence, pediatric smart pharmacy has rapidly developed, emerging as a new paradigm for optimizing pediatric pharmaceutical care. This review systematically summarizes innovations in service models and advances in technological applications within pediatric smart pharmacy in China over the past 5 years, including internet hospital-based closed-loop services, social platform-mediated medication education and counseling, and regional alliance-based resource sharing models. It also provides an in-depth analysis of the effectiveness of core technologies in enhancing medication safety, rational drug use, and service efficiency. Furthermore, the review proposes future development directions from the perspectives of technology advancement, service expansion, and management optimization, aiming to provide a reference for improving and widely implementing the pediatric smart pharmacy system.