Major technologic advances in diagnostic imaging continue to improve diagnostic accuracy in pediatric urology patients. Power Doppler ultrasound has been especially valuable in the evaluation of scrotal disease and may be useful in renal infections. Helical computed tomography offers advantages in the assessment of renal vascular architecture. Nevertheless, controversies in the evaluation of Wilms' tumor and urinary tract infections continue to generate as much heat as light as the role of new modalities is now under scrutiny.