During the past several years, the previously steady decline in the annual incidence of tuberculosis has reversed. Primary tuberculosis, the most common form in children, presents with radiographic findings that are quite different from the characteristic changes of postprimary tuberculosis commonly seen in adults. This article presents the common manifestations of primary pulmonary tuberculosis, endobronchial tuberculosis, and hematogenous tuberculosis that are seen in infants and children. The less common findings of pleural tuberculosis, congenital tuberculosis, and tuberculosis of the spine are also addressed. Recognition of the characteristic changes of childhood tuberculosis on chest radiographs may lead to more prompt diagnosis and earlier therapy for children with this disease.