Objective To analyze the CT image characteristics of children's pleural pulmonary blastoma (PPB). Methods Clinical data of 5 patients with needle biopsy and surgical pathology were collected in our hospital. The CT scan was performed and the CT features were analyzed retrospectively. Results There were 5 cases in total, 3 cases located at left lung and 2 located at right lung, type Ⅱ 4 cases, Ⅲ type 1 case; CT scans revealed massive lumps, irregular shapes, or large lumps occupying the entire chest. Ⅱ type inhomogeneous density, liquefied necrotic lesions center visible low density area, enhanced scan solid part of uneven light to moderate strengthening, liquefied necrotic cystic part and without reinforcement. Type Ⅲ density is uniform, enhanced scan in moderate reinforced uneven; When the lesion was large, the lung tissue and mediastinum were suppressed, and the enlarged lymph nodes were not seen, and bone destruction was not seen in adjacent ribs. Conclusion The incidence of PPB in children is low, the degree of malignancy is high, and its CT performance is lack of specificity. The diagnosis of this disease depends on pathological and immunohistochemistry.