Pediatric clinicians fill a critical role in climate justice advocacy. As inherent advocates for children, trusted messengers, and experts in children's health, pediatric clinicians can help advance climate mitigation, adaptation, and resilience measures. This article outlines diverse avenues for, and ladders of, engagement in pediatric climate health advocacy: from personal actions to reduce one's carbon footprint; to providing anticipatory guidance to families, greening clinical practice, and integrating climate and health into education; to supporting community campaigns, informing climate policy, and mentoring youth. Practical tools include engagement strategies and required skills, and real-world examples of pediatric clinicians leading climate advocacy efforts.