Imaging offers several modalities in the assessment of pediatric inflammatory bowel disease. Thesemodalities are represented by conventional barium studies, sonography and cross-sectional imaging methods such as computed tomography (CT) and magnetic resonance imaging (MRI). We brieflyreview the technical features of these techniques and our findings in cases with pediatric Crohn'sdisease, ulcerative colitis and indeterminate colitis. Choice of the appropriate imaging technique depends on the clinical setting. Thanks to technical developments, sonogaphy, CT and MRInow play an emerging role in the diagnostic process in children as well as in the adult population.Nevertheless, conventional barium studies still play a role in the assessment of the gut since they arewidely available, easily performed and clearly depict superficial changes in the mucosal layer of thegut. Cross-sectional imaging like sonography and MRI can easily depict mural thickening of Crohn'sdisease and offers a noninvasive and ionizing-free imaging modality for assessment of the smallbowel. Especially MRI with adequate intestinal distention can provide us with excellent informationon the presence, extension and activity of Crohn's disease. Nevertheless, MRI requires patient compliance that is not always easy in children. Copyright © 2009 S. Karger AG, Basel.