Pediatric cancers often have specific molecular fingerprints making them primary candidates for the development of targeted imaging techniques. Tumor-targeted tracers have the potential to substantially advance the sensitivity and specificity of imaging techniques by improving tumor detection and characterization. This article reviews various approaches to target tumors via specific tumor antigens, tumor cell surface receptors and specific surface receptors of the endothelial cells of the tumor vessels. These new applied molecular imaging techniques are expected to improve our knowledge of the biology of pediatric cancers and, ultimately, to help in the development of tailored diagnoses and therapies, which may ultimately lead to better individual long-term outcomes.