To review the cases of Kawasaki disease (KD) in a pediatric reference hospital, analyzing the associated radiologic findings in the lungs. Retrospective study of the cases of KD diagnosed at our hospital in the last ten years. We reviewed the clinical histories and imaging studies (plain-film chest radiographs and chest CT scans) of 24 patients and analyzed the radiologic findings in the lungs during the acute phase of the disease. Of the total of 24 cases reviewed, 5 (20.8%) showed alterations on plain-film chest radiographs. The mean age of onset of KD in these five patients was 2 years 5 months. Findings were interstitial pattern (n=3), alveolar infiltrates (n=3), subsegmental atelectasis (n=2), pleural effusion (n=1) and cardiomegaly (n=1). In one case, chest CT showed multiple pulmonary nodules. All findings appeared in the acute febrile phase and evolved favorably to complete resolution on radiologic studies. Radiologic findings in the lungs of patients with KD are uncommon. In our series, they were seen in 20.8% of the patients, in the acute febrile phase, due to inflammation of the lower respiratory tract or cardiac insufficiency. It is important to note that the pulmonary nodules observed in one patient are extremely rare. It is conceivable that more cases of KD presenting with small pulmonary nodules undetected at plain-film radiography might be seen as more children undergo CT.