Background: Pleuropulmonary blastoma (PPB) is a rare tumor of the chest seen in young children and recently recognized as distinct from the pulmonary blastoma typically encountered in adults. Objective: The purpose of this study is to review and describe the findings of PPB on radiography and CT in four patients. Methods: Radiographs and CT findings were reviewed in four patients with pathologically proven PPB. Results: All four cases demonstrated large masses in the right hemithorax with heterogeneous low attenuation, pleural effusion, contralateral mediastinal shift, and lack of chest wall invasion. Conclusion: When a large pleural-based mass is identified in a young child, PPB should be considered. Suggestive findings include absence of chest wall invasion, presence of pleural fluid, right-sided location, and heterogeneous low attenuation.