Discussions of pediatric nutrition and cancer usually focus on important issues of ensuring an adequate nutrient intake (enteral and parenteral) during and after the early treatment phase of care. However, information is available that suggests that vitamin status may have additional roles in the care of children with cancer. Over the last decade, investigators have reported findings that suggest that maternal preconception and perinatal vitamin intake and status influence the cancer risk of the infant and child. Others have shown a relationship between vitamin and antioxidant status and the prevalence and severity of adverse side effects for children undergoing chemotherapy. Vitamin D has potential anti-cancer activity and vitamin D status is suboptimal in many children in North America. Each of these issues is briefly presented from a perspective of prevention and treatment of childhood cancer. Pediatr Blood Cancer © 2007 Wiley-Liss, Inc.