Recent advances in artificial intelligence (AI) are revolutionizing pediatric intensive care by enhancing autonomic nervous system (ANS) monitoring.AI technologies offer real-time, holistic assessment of autonomic function, improving outcomes for critically ill children.The autonomic nervous system plays a crucial role in maintaining homeostasis during critical illness by regulating vital functions.AI-powered integrated monitoring synthesizes data from multiple physiological parameters to detect ANS dysregulation early.Machine learning algorithms trained on diverse datasets enable dynamic risk assessments based on physiological data patterns.Implementing AI models in clinical settings requires real-time data acquisition and sophisticated integration frameworks.Challenges include data heterogeneity, artifact contamination, and ethical considerations surrounding AI transparency.AI-enabled monitoring offers mechanistic insights into ANS dysregulation, guiding personalized therapeutic strategies.Integration of AI with genomic and other data layers enhances prognostication and precision medicine in pediatric critical care.AI-driven early warnings improve resource optimization, workflow efficiency, and staff burden within pediatric intensive care units.