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To describe the management and challenges of 3 paediatric cases of severe panuveitis with orbital inflammation.We present a retrospective case series of 3 children with bilateral orbital inflammation and uveitis.Three children presented to the paediatric uveitis clinic over a 2-year period with bilateral symptoms and signs of uveitis and orbital inflammation. There were 2 males and one female aged 10, 13 and 14 years. All patients had anterior uveitis and two had optic nerve swelling at the time of presentation. Orbital signs included lid swelling, proptosis, ptosis and ophthalmoplegia. All had MRI orbital scans and one had an orbital biopsy. All 3 cases improved on systemic immunosuppression (oral steroids, methotrexate and/or adalimumab). 2 cases had recurrence of anterior uveitis.Paediatric uveitis associated with orbital inflammation is a rare phenomenon and only solitary case reports are there in literature. Non-specific orbital inflammatory syndrome has been described to present differently in the paediatric population compared with adults and is commonly associated with a eosinophilia, however, none of our patients had so.Orbital involvement in paediatric uveitis is rare and requires a multi-disciplinary approach in management including paediatric Rheumatology and Oculoplastics. Biopsy may be considered if there are progressive orbital findings, lack of steroid response and persistent imaging abnormalities. All 3 cases had resolution of symptoms and signs on systemic immunosuppression.