Acute emergencies of the head and neck in children are wide-ranging. Frequently, these conditions are challenging to diagnose, mainly because clinical history and physical examinations are limited, particularly in younger children. The spectrum of conditions seen in the emergency setting can be divided depending on the specific area of involvement, as congenital, infectious, inflammatory, neoplastic, and traumatic conditions. Diagnostic imaging plays an important role in identifying the correct diagnosis. Understanding the spectrum of the different clinical presentations, imaging findings, and potential associated complications of the commonly encountered acute head and neck conditions in children may help to tailor a specific imaging protocol, to reach a prompt diagnosis, and to help to guide management.