Both clinically and on imaging, enlarged cervical lymph nodes are prevalent in the paediatric population. In the case of swollen lymph nodes, a thorough clinical examination is essential. Imaging is critical, especially when lymph nodes lack benign features or do not respond to treatment. Size, distribution, internal architecture, vascularity, and enhancement can all be assessed via imaging. Because ultrasound does not emit ionising radiation, it is a great first modality, while CT and MRI may provide further information on the deep areas of the neck and the evaluation of associated head and neck pathology. The radiologist must be aware of nodal pathology, especially nodal features that help distinguish between causes and related head and neck imaging findings in order to guide therapeutic care.