Historically, the evaluation of the pediatric chest has been accomplished via CT and conventional radiography. Our objective is to discuss and illustrate the role of US as a non-ionizing radiation alternative in the evaluation of the pediatric chest. US is a valuable tool in the evaluation of the pediatric chest. It can be used as a first-line modality in the evaluation of superficial lumps and bumps of the chest wall, diaphragmatic motion, the thymus and pleural effusions, and it can play a valuable secondary role in evaluation of mediastinal masses and pulmonary parenchymal disease.