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Reliable vital sign assessments are crucial for the management of patients with infectious diseases. Wearable devices enable easy and comfortable continuous monitoring across settings, especially in pediatric patients, but information about their performance in acutely unwell children is scarce. Vital signs were continuously measured with a multi-sensor wearable device (Everion^®, Biofourmis, Zurich, Switzerland) in 21 pediatric patients during their hospitalization for appendicitis, osteomyelitis, or septic arthritis to describe acceptance and feasibility and to compare validity and reliability with conventional measurements. Using a wearable device was highly accepted and feasible for health-care workers, parents, and children. There were substantial data gaps in continuous monitoring up to 24 h. The wearable device measured heart rate and oxygen saturation reliably (mean difference, 2.5 bpm and 0.4% SpO₂) but underestimated body temperature by 1.7 °C. Data availability was suboptimal during the study period, but a good relationship was determined between wearable device and conventional measurements for heart rate and oxygen saturation. Acceptance and feasibility were high in all study groups. We recommend that wearable devices designed for medical use in children be validated in the targeted population to assure future high-quality continuous vital sign assessments in an easy and non-burdening way.