Primary lung tumors are extremely uncommon in the pediatric population and have a limited diagnostic spectrum. In children, metastatic disease resulting from extracranial solid neoplasms is far more common than primary pulmonary malignancy, and it is primarily linked to hepatoblastoma, sarcomas, and Wilms tumors. In this chapter, we will review how to approach the common pediatric lung, pleural, and chest wall masses in children depending on the epidemiology with their specific imaging features and reporting format to narrow down the diagnosis.