Juvenile myasthenia gravis is rare, representing just 10% of all myasthenia gravis. Treatment of the juvenile form is similar to the adult form, although concerns of long-term side effects limit use of immunomodulators and thymectomy in children, especially the very young. We review the clinical course of three children with juvenile myasthenia gravis, as well as the current status of intravenous immunoglobulin and thymectomy as treatments for juvenile myasthenia gravis.