OBJECTIVE The purpose of this study was to review the findings on chest radiographs in children with Wegener's granulomatosis. METHODS The chest radiographs in 11 children with histologically proved Wegener's granulomatosis were retrospectively reviewed. The radiographs were evaluated for the presence of focal opacities, diffuse interstitial or alveolar opacities, nodular densities, cavitary lesions, hilar or mediastinal enlargement suggesting adenopathy, pleural fluid, and calcifications. RESULTS Two children had normal findings on chest radiographs. One child had a focal opacity that developed into a large, thick-walled cavitary lesion, and one child had small bilateral nodules, several of which cavitated. Seven children had diffuse interstitial or alveolar opacities, five of whom had pathologically proved pulmonary hemorrhages. In one of these seven children, a thin-walled cavity subsequently developed. Pleural effusions were present in two children, one with pulmonary hemorrhage and one with pulmonary edema. No lymph node enlargement or calcifications were observed in any of our cases. CONCLUSIONS Diffuse interstitial and alveolar opacities are the most common pulmonary findings in children with Wegener's granulomatosis, often secondary to pulmonary hemorrhage. Pulmonary nodules, with or without cavities, are less common findings in children.