Salivary gland lesions are uncommon in children and may be related to the parotid, submandibular or sublingual glands. Inflammatory lesions are the most common cause of salivary gland abnormalities in children and can be due to acute viral, acute suppurative, or recurrent acute or chronic inflammation. Intraparotid lymphadenitis may also occur, as in cat-scratch disease or in other causes of cervical lymphadenitis. Salivary gland neoplasms are rare in children, and most of them are benign including mainly hemangioma, pleomorphic adenoma, or lymphangioma. Other lesions, such as sialolithiasis, mucocele, or ranula, may also be seen. Ultrasonography should be the initial imaging study used for the examination of salivary gland lesions in children, given the fact that most of such lesions are benign and are shown up clearly by sonography. In most cases, this technique permits the differentiation of intraglandular and extraglandular lesions, and may suggest the correct diagnosis. The entire lesion could not be totally depicted by US however, and other imaging techniques such as CT or MRI may be necessary. Vascular lesions can be demonstrated more clearly through the use of color Doppler imaging. Some of the lesions may appear similar, and clinical correlation is important for the differential diagnosis. This article discusses the sonographic appearance and clinical manifestations of the spectrum of salivary gland abnormalities that may occur in children.