Juvenile dermatomyositis (JDM) may be complicated by life-threatening conditions requiring paediatric ICU (PICU) management. Here, the authors report on a retrospective study of JDM patients admitted to two French hospital PICUs, describing the causes, treatment and outcomes of these severe, little-known complications in order to improve their management. They found that primary JDM vasculopathy-related complications were the most common causes for admission to PICUs, and had a favourable outcome despite severe life- threatening events.