Background & Aim: Children who experience respiratory distress (RD) risk losing their lives. Morbidity and mortality are negatively impacted by delayed diagnosis. In emergency protocols, bedside lung ultrasonography (LUS) can be utilized as a screening technique for children with RD. As a result, less risky equipment is required, such as computed tomography (CT) scans and chest X-rays. This study compared the effectiveness of bedside lungs and portable chest X-rays in determining the cause of pediatric respiratory disease (RD). Methods: The current study was conducted at the Pediatric Intensive Care Unit of Assiut University Children's Hospital. It was conducted during the period between March 2020 and March 2022. 150 children with acute respiratory distress were enrolled in the study. All children were subjected to lung ultrasound evaluation.