In the past five decades the survival rate of children with cancer has increased significantly. In the beginning of the 1960s approximately 30% of children survived whereas this figure is approaching 80% nowadays. This will also have an impact on adult radiology as survivors of childhood cancer have shown to have an estimated 10% increased incidence of subsequent neoplasms. Paediatric radiology plays an important role in the diagnosis, staging, treatment (interventional radiology) and follow-up of childhood cancer. In order to fullfil its role the radiologist should have clinical knowledge about the epidemiology, presentation and treatment of childhood cancer. From a radiological point of view he/she should have knowledge of state-ofart imaging techniques and the implication of these techniques on cancer staging. The paediatric radiologist should play a pivotal role in imaging protocols, not only on a local level but also on an international level through, e.g. the International Society of Paediatric Oncology. With respect to reporting childhood cancer there is an ongoing debate on which measurements should be used. Historically paediactric cancer response assessments are based on 3-D measurements. However, with the introduction of new European guidelines it is expected that pharmaceutical companies will insist on the use of RECIST criteria in trials.