Each year in France, 42,000 children receive spa therapy, which is covered by the national health care insurance system. In over three cases out of four, the treatment is ordered by the child's physician for respiratory tract disease which fails to respond adequately to conventional therapy. Asthma, recurrent bronchitis, and spasmodic cough are the main indications in pneumo-allergology; seromucous otitis media, naso-sinusitis and refractory pharyngitis are the most common pediatric ENT diseases treated in spa centers. The two main types of mineral water used are sulfur-rich waters in patients with prominent infection and chloride and bicarbonate-rich waters when allergy is the main problem. Experimental studies point to the fact that these waters have immunomodulating effects. However, other therapeutic interventions in spa centers, including rehabilitation and health education, also play a role. Evaluations of spa therapy for respiratory tract diseases carried out by government agencies have demonstrated decreases in school absenteeism and above all in the use of drugs in treated patients. The future of pediatric spa therapy will likely depend on the development of preventive interventions in spa centers.