There are several challenges associated with providing specialized pediatric oncology care in tertiary hospitals in India. These challenges include: 1. Lack of specialized pediatric oncologists: There is a shortage of pediatric oncologists in India, especially in rural areas, making it difficult to provide specialized care to all children in need. 2. Limited infrastructure: Tertiary hospitals in India often lack the necessary infrastructure and facilities required for pediatric oncology care, such as specialized pediatric wards, radiation therapy units, and state-of-the-art diagnostic equipment. 3. Financial constraints: Costly treatment options, including chemotherapy and radiation therapy, pose a significant financial burden on families. Limited access to health insurance coverage further exacerbates this challenge, making it difficult for children to receive timely and appropriate care. 4. Limited research and clinical trials: There is a lack of sufficient research and clinical trials focusing on pediatric oncology in India. This hinders the development of evidence-based protocols and treatment guidelines for children with cancer. 5. Lack of public awareness: Limited public awareness about pediatric oncology leads to delayed or misdiagnosis, creating barriers to early intervention and optimal treatment outcomes for children. Addressing these challenges would require increasing the number of trained pediatric oncologists, improving infrastructure, expanding health insurance coverage, promoting research and clinical trials, and creating awareness campaigns to educate the public about pediatric cancer.