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Background: Lung illnesses account for the majority of problems that affect newborns and children, as well as the main cause of death for children under the age of five. Thus, prompt and precise diagnosis is critical to effective therapy and better patient outcomes for those suffering from lung conditions. This study aimed to assess the role of lung ultrasonography as a diagnostic tool in different pediatric lung diseases. Patients and Methods: This case-control study was conducted at Pediatric Department, Benha University Hospital during the period from December 2022 to December 2023. It included 120 participants presenting with symptoms and signs suggesting lung diseases, the average age of the participants was 5.27 years with a standard deviation of 2.21. Results: Chest X-ray was (100%) diagnostic in different studied lung diseases, except for bronchitis where it was diagnostic in 69.7% of cases. Chest ultrasound was diagnostic in 84.8% of patients with bronchitis and (75%) of patients with pneumonia, while it was 100% diagnostic in cases with pneumonia complicated with effusion, collapse, and pneumothorax. In diagnosis of bronchitis, based on chest radiography (CXR), as a reference standard, US had overall sensitivity, specificity, and diagnostic accuracy of 100%, 50% and 84.8% respectively. Kappa statistics revealed significant moderate agreement between LUS and X-ray (kappa =0.582, p<0.001). In diagnosis of pneumonia, US had overall sensitivity, and diagnostic accuracy of 75% and 75% respectively. Conclusion: LUS has good sensitivity and specificity in diagnosing and following up common pediatric lung diseases at least as accurate as chest X-ray. [ABSTRACT FROM AUTHOR]