Background <p>Cone-beam computed tomography (CBCT) provides high-quality, three-dimensional imaging of the maxillofacial region. However, its use in pediatric patients remains controversial due to radiation dose concerns and the sensitivity of immature anatomical structures to radiation damage.</p> <p>This study aims to determine the prevalence and indications of dental CBCT usage in children.</p> Methods <p>All CBCT images of pediatric patients under 15 years old, obtained from 2018 to 2025 at a university hospital, were retrospectively reviewed. Demographic data, indications for CBCT, imaging field of view (FOV), and average kVp and mA values were evaluated. Descriptive statistics and Chi-square tests were used for data analysis.</p> Results <p>A total of 266 CBCT images from children aged 5–14 years (mean age 11.06; 128 females, 138 males) were included. The prevalence of CBCT among all pediatric patients in this age group was found to be 2.1%. Of the CBCT scans, 175 were for the pathologies from maxilla, 88 from the mandible, and 3 involving both jaws. Imaging was most commonly performed in the anterior (incisor) region for both sexes, with a statistically significant higher rate in males (p&lt;0.001). Surgical indications accounted for 81.6% of cases, while orthodontic indications comprised 18.4%. The most common reasons for CBCT imaging were impacted teeth (29.3%), pathological lesions (21.4%), supernumerary teeth (17.3%), and mesiodens (15.8%). The most frequently used FOV was 15x12 cm.</p> Conclusions <p>The prevalence of CBCT use in pediatric patients is low and is primarily preferred before surgical interventions for impacted teeth and cyst/tumor-like lesions.</p>