Molecular diagnostics are an essential component of paediatric oncology care, providing critical information for disease classification, risk stratification and the selection of targeted therapies, ultimately improving patient outcomes. This study presents the results of the 2024 Latin America Regional Advisory Committee and Paediatric Oncology Latin American Society regional survey, which assessed the availability, accessibility, quality and key challenges associated with molecular diagnostics for paediatric malignancies across Latin America. While molecular testing is available in several countries, access remains heterogeneous and inconsistent, particularly in public healthcare settings. Survey findings highlight significant barriers, including financial limitations, a shortage of trained personnel and insufficient laboratory infrastructure. The study also explores potential strategies to strengthen regional capacity through international collaborations, sustainable financing models and targeted workforce development initiatives, to promote equitable access to precision diagnostics for all children with cancer in the region.