Abstract Neurological deficits in the paediatric age group are much rarer than in adults; however, it is an urgent condition that relies heavily on imaging for a prompt accurate diagnosis. Neurological deficits caused by cerebrovascular diseases are defined as stroke, whereas conditions manifesting with neurological deficits without underlying cerebrovascular diseases are referred to as stroke mimics. To the best of the authors' knowledge, there is a lack of systematic pictorial review that collectively describes the imaging of neurological deficit in children. The purpose of the present series is to discuss the causes and imaging appearance of neurological deficits in childhood, based on the experience of a tertiary paediatric referral centre These are broadly categorised into stroke, infection, inflammation, metabolic disorder, cerebral neoplasms and drug poisoning. Different entities of stroke and their respective imaging findings are discussed. Paediatric stroke can further be divided into arterial ischaemic stroke, sino-venous stroke, haemorrhagic stroke and hypoxic–ischaemic encephalopathy.