Adrenal lesions in children may manifest as an abdominal mass or as an endocrine disease. The role of diagnostic imaging in the former case is to differentiate between renal and adrenal masses; in the latter case, the role of diagnostic imaging is to lateralize the source of endocrinopathy to one or both adrenals. During the past decade, cross sectional imaging techniques, such as ultrasonography (US), computed tomography (CT), and magnetic resonance (MR) imaging, have replaced intravenous urography and other more invasive radiographic techniques for evaluation of adrenal abnomalities in childeren. This essay provides a review of the various adrenal disorders encountered in children and the characteristic imaging findings, with emphasis on the relative role of US, CT, and MR imaging in different age groups. The following topics are discussed, normal adrenal anatomy; imaging techniques; lesions originating from adrenal cortex such as hyperplasia , storage disease, adenoma, carcinoma, myelolipoma and haemorrhage; lesions derived from the adrenal medulla (pheochromocytoma and neuroblastoma) and lesions affecting both adrenal cortex and medulla such as cysts and metastases. This essay contains 5 representative cases: 1 case of adrenal haemorrhage and 4 cases of neuroblastoma.