Melatonin, a tryptophan derivative, is synthesised in mammals mainly in the pineal gland. It coordinates the biological clock by regulating the circadian rhythm. Its production is dependent on light and its concentrations change with age. Thanks to its specific chemical structure, melatonin is capable of crossing all biological barriers in the organism and affecting other tissues and cells, both in indirect and direct ways. Its mechanism of action involves binding with membrane receptors, nuclear receptors and intracellular proteins. Melatonin shows antioxidant activity. Moreover, its immunomodulatory and antilipid effects as well as its role in secreting other hormones, such as prolactin, luteinizing hormone, follicle-stimulating hormone, somatotropin, thyroliberin, adrenocorticotropin hormone or corticosteroids, are essential. In the recent years, research studies have been mainly focussed on the potential influence of melatonin on the aetiology and development of various disease entities, such as sleep disorders, gastrointestinal diseases, cancers, psychiatric and neurological conditions, cardiovascular diseases or conditions with bone turnover disorders. Indications for melatonin use in paediatrics are being discussed more and more frequently. Among others, authors debate on its use in dyssomnias in children with neurodevelopmental disorders, such as attention deficit hyperactivity disorder, supportive treatment in febrile seizures and epilepsy as well as potential use in paediatric anaesthesia. The molecular mechanism and broad-spectrum action of melatonin have not been sufficiently researched and its clinical relevance is often underestimated. This hormone is a promising link in achieving alternative therapeutic solutions.