Objective To analyze the CT and MRI manifestations of germ cell tumor in children and adolescents. Methods Clinical data of 24 patients with GCTs were collected, and CT and MRI characteristics were analyzed and compared with pathological analysis. Results There were 13 cases of germinal cell tumor, and the CT scan was slightly lower or equal density, and the MRI showed a low T1WI and a high signal of T2WI, accompanied by calcification and microcystic changes, and was significantly enhanced. In 5 cases of teratoma, the density/signal was mixed, and the tumor contained different proportions of fat and calcification, which enhanced the unevenness. In 3 cases of endodermal sinus tumor, CT scan showed low density, and MRI scan showed a relatively uniform T1WI low and T2WI high signal. Some lesions had mucous cystic lumen, and enhanced scanning was uniform or non-uniform. In 2 cases of embryonic carcinoma, CT/MRI scanning density/signal was mixed, with obvious liquefaction necrosis, inhomogeneity enhancement, and significant edema around the tumor. In the case of mixed germ cell tumor, the density/signal was mixed, and enhanced obviously. Conclusion There is a variety of images of GCTs in children and adolescents, and some tumors have certain characteristics, which can help to improve the accuracy of diagnosis in combination with clinical features such as tumor markers and age of onset.