The blood flow pattern within and around soft tissue tumors was analyzed to determine if color Doppler images could aid in the differential diagnosis. The study comprised 49 children with 50 masses: 24 inflammatory lesions, eight malformations, six neoplasms, five cysts, and seven traumatic lesions. A peripheral pattern (flow around the mass) was noted in eight of 50 lesions (16%). A mixed pattern (flow within and around the lesion) was noted in eight of 50 lesions (16%), and a central pattern (flow in the central region of the mass) was noted in 10 of 50 lesions (20%). Flow was absent in 24 lesions (48%). The peripheral pattern was observed only in abscesses. The other patterns were seen most frequently in lymphadenitis but were not specific for that diagnosis. Our experience suggests that color Doppler imaging is useful only in the diagnosis of abscess. In other lesions, color Doppler imaging alone is insufficient for diagnosis.