Pectus excavatum (PE) is the most common congenital chest wall deformity in children. It affects 1 in every 300-1000 live births with a male to female ratio of 5:1. Most of the patients present in their first year of life. During the teenage years, patients may have exercise intolerance and psychological strain because of their chest wall deformity. The Nuss and Ravitch procedures are established methods of surgical correction of PE. An index of severity known best as the Haller index, typically evaluated with computed tomography scan, when measuring greater than 3.2 is considered to indicate moderate or severe PE and is a prerequisite for third-party insurance reimbursement for these corrective procedures. This article reviews the clinical features of PE, the role of imaging, and the opportunities for radiation dose reduction.