Imaging is crucial for diagnosing, staging, and managing pediatric head and neck tumors, a diverse group accounting for 12% of childhood neoplasms. Prompt and accurate diagnosis is essential given their responsiveness to treatment. Evaluation necessitates a comprehensive understanding of complex head and neck anatomy, particularly fascial compartments, to localize and assess lesion extent. Pediatric imaging poses unique challenges due to smaller anatomy requiring high resolution, radiation sensitivity, and frequent need for sedation. A multimodality approach utilizing ultrasound, CT, MRI, and nuclear medicine is often employed, guided by clinical context. This chapter provides an evidence-based approach, reviewing key imaging features and discussing modality advantages/limitations. It summarizes consensus guidelines from leading societies, emphasizing ultrasound for superficial lesions, MRI for soft tissues, and CT for bone. The chapter also offers a structured radiological reporting template for consistent communication of findings, underscoring the need for individualized imaging decisions within established frameworks.