Chest radiographs have been useful for the incidental detection and initial imaging evaluation of clinically suspected central airway narrowing in pediatric patients. However, cross-sectional imaging, such as computed tomography (CT), is frequently required for confirmation of diagnosis, further characterization, and preoperative evaluation of surgical lesions. Recent rapid technologic advancement in CT has allowed CT to assume a pivotal role in the noninvasive evaluation of tracheobronchial narrowing in children, in particular with multidetector computed tomography with postprocessing techniques, including multiplanar reformations and 3-dimensional reconstructions. In this article, the authors review the multidetector computed tomography technique for evaluation of central airway narrowing in children, with emphasis on the use of multiplanar reformations and 3-dimensional reconstructions in the imaging evaluation of the spectrum of intrinsic and extrinsic causes of central airway narrowing in children.