Rotavirus is the leading cause of severe childhood gastroenteritis. Each year, rotavirus is responsible for about 25 million clinic visits, two million hospital admissions, and 180 000-450 000 deaths in children under 5 years of age globally.1 2 3 Although rotavirus infection is prevalent worldwide, most deaths from this infection occur in developing countries (fig 1?). Gastroenteritis caused by rotavirus cannot be clinically distinguished from that caused by other enteric pathogens; diagnosis requires testing of fecal specimens with commercially available assays. However, rotavirus is not routinely tested for in patients with gastroenteritis because the results do not alter clinical management, which relies mainly on appropriate rehydration therapy. Orally administered live attenuated vaccines that mimic natural infection offer the best protection against rotavirus. Two licensed rotavirus vaccines have been available since 2006 and have been implemented in many countries. We review approaches to diagnosis, management, and prevention of rotavirus gastroenteritis.