Ultrasound (US) of the paediatric chest has become an established imaging tool that may supplement plain film findings helping to reduce or tailor other ionizing (sectional) imaging in a variety of paediatric conditions such as sequestration or pneumonia. US has been shown to offer valuable imaging alternatives, both reliably enabling diagnosis without need for ionising imaging such as in diaphragmatic palsy (traditionally diagnosed by fluoroscopy) and revealing additional information in patients with equivocal findings on radiographs or replacing follow-up examinations (for example, in pleural effusion). This review outlines the technical requisites for paediatric chest US applications and will discuss its diagnostic potential. Furthermore, it will consider US restrictions, mention some rare applications, and discuss the potential role of chest US in imaging algorithms of certain conditions.