In recent years, anatomically based ultrasound is one of the most exciting advances in technology in relation to pediatric regional anesthesia. The use of ultrasound in neuraxial anesthesia in adults is somewhat limited because of the reduced visibility of the spinal canal resulting from poor ultrasound beam penetration through the ossified bony vertebral column. In theory, ultrasound could be of much greater value in the young pediatric population where there is limited ossification, thus allowing good visual resolution of the anatomy and block-related equipment or solutions.