The study covers the problem of insufficient regulation of pediatric deep brain stimulation (DBS) in Russia, which causes neuroethical dilemmas and risk of unjustified expansion of indications. The study is relevant because of growing use of DBS in children with severe neurological disorders and lack of adapted standards. The aim of the study is to identify gaps in regulatory system and develop recommendations for ethical and clinical regulation of DBS in children. The current clinical recommendations of the Ministry of Health of the Russian Federation, international consensuses and protocols of leading Russian centers were used as a basis for the research. The main methods included analysis of regulatory documents, comparative and critical analysis of existing standards and ethical approaches. The results show that Russian practice lacks age-specific standards and assessment algorithms despite the regulations. The risks of expanded indications and pressure on patients and their families, which may lead to unregulated experimentation, have been identified. As a conclusion, the need to develop specialized recommendations and strengthen ethical standards to ensure safety and effectiveness of DBS use in children is proposed.