Pediatric rhinosinusitis are common encountered disorders caused by different pathogenic factors or predisposing conditions with a proportion of them progressing to chronicity with a meaningful impact on quality of life and related adverse effects. A deep understanding of pathophysiology, disease course and prognosis are the fundamental building block to an appropriate management of rhinosinusitis in order to avoid risks related to complications. This review gives concise answers to clinicians who want to know "when do we need imaging?" "what do we aspect from imaging?" and "what are the appropriate imaging modalities in different settings?” in pediatric patients in order to increase the appropriateness of imaging examinations.