PURPOSE: Lung ultrasound (LUS) has been widely used for detecting pneumonia in children. Although LUS offers multiple advantages, its diagnostic accuracy compared to an imaging gold standard, e.g., computed tomography (CT) is in question. We evaluated the existing literature comparing the use of LUS for diagnosing pneumonia in children to CT. METHODS: PubMed, EMBASE and Scopus databases were searched for relevant studies published from inception to June 13, 2024, using controlled vocabulary (MESH, EMTREE) with keywords. RESULTS: The initial search identified 1065 articles. After the removal of duplicates (n = 350), the abstracts and titles of 715 studies were screened. 34 relevant studies were reviewed in detail for eligibility and shortlisted to 19 studies. Only 5 usable studies were identified. Of the five studies, three were published in journals that are not indexed in MEDLINE. The study with largest sample size (949 children) reported a sensitivity of LUS of 0.906 with 0.661 accuracy in comparison to chest CT. CONCLUSION: There was very limited and relatively low-quality current evidence regarding the accuracy of LUS in comparison to CT for diagnosing pneumonia in children.