Chest trauma is the second most common traumatic cause of death in childhood. In children, the chest wall is more compliant than in adults, which results in lesser rib fractures but may cause intrathoracic injuries, due to a greater transmission of energy to the lungs and other intrathoracic organs. Besides a chest x-ray, nowadays the thoracic ultrasound examination (Extended Focused Assessment with Sonography in Trauma [E-FAST]) is used in the trauma bay. If injuries to the mediastinal structures are suspected, a contrast-enhanced computed tomography (CT) of the thorax should be performed. Most pediatric patients with chest trauma can be treated non-operatively with some children who may need a chest drain. Surgical treatment by means of thoracoscopy or thoracotomy is only necessary in selected cases. Pelvic fractures in childhood are the result of high-energy trauma and therefore more frequently found in polytraumatized children. More than 40 % of children with significant pelvic trauma have a severe concomitant thoracic injury. Next to the pelvic ring stability examination, the pelvic X-ray represents the most important diagnostic tool. A contrast-enhanced CT is the method of choice for a detailed description of pelvic fractures. Stable pelvic fractures can be treated conservatively and less than 10 % of pelvic fractures in children require an operative treatment with osteosynthesis.