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Abstract Peripherally inserted central catheters (PICC) are used extensively in neonates and children and insertion of these thinnest catheters is a very delicate procedure. The purpose of this study is to determine the technical and functional aspects concerning image guided peripherally inserted central catheter (PICC). This prospective study done including 20 pediatric patients, 10 patients of them undergo peripheral inserted central catheters while, the other 10 patients undergo traditional CVCs using ultrasound and / or fluoroscopy guidance for different indications. Venous access devices (VADs) were successfully provided for 20 patients. There were 12 males (60%) and 8 females (40%) with a mean age of 4.91 years (range, 0-15 years). The right internal jugular vein was the main site of entrance for 6 cases (30%); 3 patients coming for BMT and 3 patients on regular hemodialysis. The left internal jugular vein was used for 3 cases (15%) with chronic renal failure. The right subclavian vein was used in 1 case (5%) with end stage renal disease. The right internal mammary vein was used in 1 case (5%). The left femoral vein was used for 5 (25%) PICC lines with septic shock and inotropes. The right femoral vein was used for 2 (10%) PICC lines with multisystem organ failure. The right basilic vein was used for 1 PICC line (5%) and the left greater saphenous vein was used in another 1 PICC line 5%. Image guided PICCs are considered as a feasible, safe and valuable option for central venous access in pediatric patients |