In children with suspected cranial pathologies, three-dimensional (3D) computed tomography (CT) imaging is superior to other modalities. It can help differentiate actual pathology from normal or variant appearances. Sutures and fontanelles, synostosis, abnormalities of head shape without craniosynostosis, congenital calvarial defects, cranial fractures, bone tumors, and postoperative cranial vault can be assessed easily with 3D CT imaging. We aimed to discuss the common normal, variant, and pathological findings that 3D CT imaging can aid to diagnose as well as explain the usefulness of 3D CT imaging in the diagnosis of calvarial pathologies.