Many inherited metabolic disorders cause movement disorders in children. This review focuses on chorea, dystonia, myoclonus, tremor, and parkinsonism. Broad categories commonly responsible for pediatric movement disorders include mitochondrial disorders, organic acidemias, mineral metabolism and transport disorders, neurotransmitter diseases, purine metabolism disorders, lipid storage disorders, and disorders of creatine metabolism. Each movement disorder can be caused by many different inherited metabolic disorders and several of the inherited metabolic disorders can cause multiple movement abnormalities. Dietary modifications, medications, and increasingly specific therapy can improve outcomes in children with movement disorders caused by metabolic disorders. Recognition and characterization of secondary movement disorders in children facilitate management of the abnormal movements and diagnosis, and possible treatment, of an underlying metabolic disorder.