Objective: Neuroblastomas and Wilms' tumors are frequent pediatric solid tumors. The first is frequently detected in the adrenal gland and the second develops in the kidneys. The extension through the vena cava and the lung metastases are frequent in Wilms' tumors and are rarely in neuroblastoma. We present the cases of three children with abdominal tumors with thrombus in the inferior vena cava and pulmonary metastases were discovered yet demonstrated a stage 4 neuroblastoma. Method: The three male patients were between 23 and 48 months old. They presented an abdominal mass, near the superior pole of the kidney. Thrombus of the vena cava was evoked on imaging studies in all cases and pulmonary metastases were always found. Catecholamine metabolites were present in the first case and negative in the two others. Two out of three patients had a radical nephrectomy. Results: The pathological analysis always found a neuroblastoma poorly differentiated or undifferentiated without MYCN amplification and confirmed the tumoral thrombus in the second case. The evolution of the two first patients was unfavorable and the third is alive. Conclusion: Invasion of the inferior vena cava and pulmonary metastases in children with neuroblastoma is uncommon and can modify the surgical management.