Ultrasound is a first-line imaging tool for the evaluation of gastrointestinal conditions in children. Although pediatric gastrointestinal anatomy is similar to that of adults, some differences—such as larger lymphoid tissue in the ileum and the smaller size of some structures—require specific adjustments during ultrasound examination. This chapter outlines the main sonographic findings of common conditions, including hypertrophic pyloric stenosis, intussusception, enteric duplication cysts, malrotation, midgut volvulus, intestinal polyps, omental infarction, and Meckel’s diverticulum. Key ultrasound signs, such as the “target sign” in intussusception and the “whirlpool sign” in volvulus, are highlighted. The use of high-frequency probes and dynamic assessment improves diagnostic accuracy. Early recognition of these patterns can support prompt diagnosis and treatment, reducing the need for more invasive procedures.