Poor palatability of oral drug formulations used for young children negatively influences medication intake, resulting in suboptimal treatment. Some children are more sensitive to bitter tastes than others. Bitter tasting status is currently assessed by phenotyping with 6-n-propylthiouracil (PROP) as a bitter probe. Recent studies showed that interindividual differences in PROP sensitivity can be largely explained by three SNPs in TAS2R38, encoding a bitter taste receptor. Gustin, involved in the development of taste buds, and the sweet receptor genotype potentially explain remaining parts of PROP sensitivity variability. Other TAS2 receptor bitter receptor genes may also play a role in bitter aversions. Dependent on their genotype, children may have different medication formulation preferences. Taste genetics could improve drug acceptance by enabling better-informed choices on adapting oral formulations to children’s taste preferences. This paper presents an overview of recent findings concerning bitter taste genetics and discusses these in the context of pediatric drug formulation.