Objectives To evaluate pediatric neck masses with magnetic resonance imaging (MRI). Methods In this retrospective study, 140 children with neck masses underwent MRI were collected from May 2006 to December 2013. Of them 34 cases went through pathological examinations. The results of MRI diagnosis and pathology were compared in 34 cases. Results In 140 children with neck masses diagnosed by MRI, 103 (73.6%) cases were benign lesions, including 62 vascular malformations, 30 hemangiomas, then cysts, hamartoma, infectious lumps etc., 29 (20.7%) were malignant tumors, including 22 lymphomas, 3 rhabdomyosarcomas, 3 Langerhans cell histiocytosis, 1 neuroblastoma, and 8 (5.7%) cases were undeter-mined masses. Four in 103 cases with benign lesions were performed by pathological examination and all had been con-firmed. Tewenty-five in 29 cases with malignant tumors were performed by pathological examination and 22 cases had been confirmed. Conclusion MRI can help to diagnose the pediatric neck masses and to guide the treatment and follow-up.