BACKGROUND: As an auxiliary examination, lung ultrasound (LUS) is widely used in the clinical diagnosis of pneumonia. The purpose of this study was to investigate the accuracy of LUS detection of community-acquired pneumonia (CAP) combined with pulmonary consolidation in children. METHODS: Children who were diagnosed with CAP at a children's hospital in 2023 and who underwent lung computed tomography (CT) and LUS at the same time were included. The Cohen kappa coefficient was used to evaluate the concordance between LUS and CT. RESULTS: A total of 6,705 children with CAP were enrolled, among whom 3,485 (51.98%) were male, with the mean age being 79.38±33.91 months. Of these children, 658 had pleural effusions and 3,799 had pulmonary consolidation. According to the consistency test, there was good agreement (κ=0.844) between LUS and CT examinations in assessing pulmonary consolidation. In detecting pulmonary consolidation, LUS demonstrated a sensitivity of 92.10%, a specificity of 92.53%, a positive predictive value of 94.16%, and a negative predictive value of 89.96%. For detecting pleural effusion, LUS and chest CT had a moderate degree of consistency (κ=0.457). CONCLUSIONS: LUS demonstrated good accuracy in diagnosing pulmonary consolidation in children with pneumonia. When concurrent pulmonary consolidation is suspected from the diagnostic work-up of pneumonia, LUS may be a valuable supplementary method.