Decision making in pediatric cancer is particularly difficult. There may be uncertainty about prognosis, and long-term survival estimates from trials may not be applicable to current patients. There are many motivations to conduct research into patient and provider decision making. This review discusses three approaches to understanding decision making, namely decision analysis, the threshold technique and discrete choice experiment. These techniques are applied to situations in pediatric oncology to illustrate how the results may be useful for patient care. Future work in pediatric oncology decision making should focus on methods to facilitate decision making and elicit preferences from children themselves. Pediatr Blood Cancer 2013; 60: 558–563. © 2012 Wiley Periodicals, Inc.