This review highlights further advances in imaging of the central nervous system in infants and children. Gadolinium diethylenetriamine penta-acetic acid is now widely used as an adjunct to magnetic resonance (MR) imaging in children, aiding the diagnosis of inflammatory or neoplastic disorders. MR imaging enables fine detail of the brain to be displayed. High signal intensity foci have been identified in the basal ganglia in patients with neurofibromatosis. Central nervous system abnormalities in herpes encephalitis type II, Lyme disease, and multiple sclerosis in children have been well demonstrated by MR imaging. The role of MR imaging angiography is evolving. MR imaging spectroscopy of some childhood tumors demonstrates a pattern suggestive of ischemia. Three-dimensional computed tomography is superior to conventional radiography and computed tomography for the diagnosis of craniosynostosis. The alterations to cerebral blood flow in neonates undergoing extracorporeal membrane oxygenation have been documented by color Doppler imaging, computed tomography, and MR imaging. Single-photon emission tomography may demonstrate perfusion abnormalities in children with cerebral palsy.