Emergency image-guided interventions in pediatric patients frequently require different interventional skills and techniques to accommodate the patient’s size and a spectrum of anatomical and developmental variants. In this chapter, we describe pediatric interventions that are commonly performed emergently, divided into anatomical areas. The procedures in the chest include aspiration or drainage of pleural effusion, pneumothorax, lung abscess, catheter-directed thrombolysis (CDT) of massive or sub-massive pulmonary embolism (PE), and bronchial artery embolization (BAE) for the treatment of massive hemoptysis. Abdominal procedures described include abscess drainage; management of gastrostomy tubes, gastrojejunostomy tubes, and cecostomy tubes; embolization for the management of massive gastrointestinal (GI) bleeding; and embolization for splenic or hepatic trauma. The renal procedures include nephrostomy tube placement and embolization for renal trauma. Musculoskeletal procedures, including arthrocentesis for suspected septic joint and bone biopsy for osteomyelitis, will also be reviewed. We also describe issues related to emergent vascular access in children.