Introduction: The comprehensive study of cavitary lung lesions, congenital diaphragmatic anomalies, and pneumonia in children depends to a greater or lesser extent on chest X-rays. Objective: To describe the importance of X-rays in the accurate diagnosis of cavitary lung lesions and congenital anomalies in children. Development: Cavitary lesions—gas-filled spaces within an area of pulmonary consolidation or a mass/nodule—are linked to various benign and/or malignant pathologies. The diagnostic criteria depend more on CT scans than on X-rays. In the case of diaphragmatic hernias, X-rays are mainly used in cases that could not be diagnosed in the prenatal stage. For the differential diagnosis of pneumonia in pediatrics and its evolution, it is necessary to consult chest radiological studies, due to the variety of infectious agents. Conclusions: Chest radiography allows the location, extent, lobar or segmental involvement, and associated complications to be established; it can also provide guidance on the etiology, given the existence of atypical viral or bacterial pneumonias. Radiology is of great importance in the accurate diagnosis of cavitary lung lesions and congenital anomalies in the pediatric population and contributes significantly to the early diagnosis and effective management of these pathologies
