Excellent results can be obtained with conservative therapy of intramural duodenal hematomas, and thus the radiologist plays a crucial role in their management and followup. Six children in in whom intramural duodenal hematoma was diagnosed, based on clinical, laboratory, and radiographic findings, were managed conservatively. Treatment consisted of restricted oral intake, intravenous infusion of fluids and electrolytes, and nasogastric suction when indicated. The satisfactory response of these patients to nonoperative therapy was demonstrated on serial upper gastrointestinal studies and by regression of clinical signs and symptoms.