Clinical issue: Children’s interstitial lung disease (chILD) encompasses a large group of rare and heterogeneous pulmonary disorders associated with diagnostic challenges for all disciplines. Due to the substantial morbidity and mortality, a timely and accurate diagnosis is required for optimal patient care. Standard radiological methods: Radiology plays a crucial role in the diagnosis of chILD; computed tomography (CT) represents the current gold standard imaging modality. Practical recommendations: To make an accurate diagnosis, a systematic approach in a multidisciplinary team is essential. CT confirms the presence of chILD and enables exclusion of more frequent disorders. In conjunction with patient history and clinical presentation, knowledge of imaging patterns in chILD may lead to a specific diagnosis; otherwise unspecific changes can narrow differential diagnosis, guide further diagnostics, and prevent more invasive procedures.