The French healthcare insurance databases have proven to be valuable tools for the conduct of pharmaco-epidemiological studies with regards to the size of the population covered and that of the available information. Their wider use in the field of pediatric pharmacoepidemiology is of paramount importance given the existing gap of knowledge in the use and effects of many drugs in children and adolescents as well as the difficulties to conduct clinical research studies in this age population. However, because of the architectural complexity of these databases and their specificities, specific expertise should be developed in order to ensure the reliability of studies based on these data. To this purpose, it is important to facilitate knowledge sharing through national collaborative projects.