Chronic diseases of the lung parenchyma (CDoLP) in children encompass a vast number of distinct clinico-pathological conditions. The prevalence of CDoLP has continued to increase in the last 10–15 years and the paediatric radiologist will therefore have to become more familiar with the imaging appearances of CDoLP. This review highlights some of the key imaging appearances of CDoLP, focussing mainly on airways disease. We also explore issues around technique optimisation and dose minimisation that remain of paramount importance in children.