Primary fibromyalgia syndrome (PFS) is a common and characteristic rheumatologic condition manifested by diffuse musculoskeletal aches, pains, and stiffness frequently modulated by various factors, e.g., weather, physical activity, sleep quality, and anxiety/stress, and accompanied by discrete tender points at typical soft tissue sites. Although well-recognized in adults, this entity has not been reported separately in juveniles. This study documents PFS in 33 juveniles who presented at age 17 or younger and compares their findings with those in age- and sex-matched normal control subjects. As in adult PFS patients, associated non-musculoskeletal symptoms were common, including fatigue, poor sleep, anxiety/stress, headaches, and paresthesias. Physical examination revealed multiple tender points at characteristic soft tissue sites and no objective evidence of arthritis. Routine laboratory test results were normal or negative. Juvenile PFS is often misdiagnosed. Recognition of this common rheumatologic condition in juveniles is important in order to avoid unwarranted investigations and improper management.