Cultural specificity is one of the most discussed topics in studies of translated children’s and young adult literature. It is, after all, at the heart of the paradox in translating for children, in particular the straddle between the desire to introduce young readers to the culturally different and the fear that young readers would drop out if a text contains too much strangeness. This chapter first clarifies how this tension between ‘foreignisation’ and ‘domesticating’ is complicated by three typical features of literature for children: the asymmetric communication, the dual audience and the multimodal character. Next, it examines how the approaches to the translation of cultural specificity changed over time in pioneering studies on the translation of children’s literature. In a third part, the chapter focuses on CSIs that are most often adapted when translating for children: names, food and drinks, school life and children’s games and parties. Not only concrete items but also sensitive topics such as sex, violence and undesirable behavior may be very much culture-specific and therefore deeply transformed when they travel across different cultural areas. These cultural adaptations clearly illustrate the impact of pedagogical norms, child images and ideology. As not only the verbal but also the visual language in children’s books can contain culture-specific items, illustrations too can be changed to suit the context of the target culture. The conclusion lists factors that may determine whether and how young readers come into contact with cultural specificity in translated books and signals a changing attitude toward the translation of CSIs in our increasingly globalised and multicultural world.