The promise of personalized medicine, first proposed at the end of the last century, is becoming more of a reality as the price point for performing whole genome, transcriptome, and other “omic” sequencing continues to drop. While researchers and clinicians have long been assessing the molecular profiles of disease, particularly in the field of oncology, this approach is being used more often to inform clinical decision-making as it pertains to diagnosis, prognosis, and therapy. Not unexpectedly, the science of genomic medicine is moving faster than its companion discussions surrounding the ethical, legal and social consequences of genomic medicine. These issues are particularly troublesome when the patient in question is a minor. Today’s discussions will provide an overview of current next-generation technologies currently in use, the clinical applications for whole genome and transcriptome data, the limitations of data acquired through next-generation technologies, and the emerging controversies surrounding the use of these data and approaches, particularly as they pertain to a pediatric population.