The manufacturer of infliximab recommends infusion over 2 to 3 hours. In 16 children who received 133 standard 2- to 3-hour infusions, followed by fifty 1-hour infusions, chart review revealed a frequency of infusion reactions of 2% with both infusion protocols (3/133 and 1/50). The first reaction with the rapid infusion occurred in a patient who had experienced an identical reaction with the longer infusion, but was mistakenly not premedicated. Our data suggest rapid infusion over 1 hour in selected pediatric patients is safe and cost-effective. Compared with reported adult data, our data suggest similar or lower frequency of adverse events.