US is useful in the imaging of the spine, although MRI is the modality of choice, especially in young infants because posterior neural arch is incompletely ossified and US can image the spinal canal and its contents. Spinal dysraphism or postoperative neural arch defect also provides acoustic window to visualize the internal structures. High frequency linear array transducers are usually preferred and scanning is performed in prone position creating a kyphotic curvature to facilitate the acoustic window. Images are obtained in transverse and sagittal planes. Spinal cord shows as a relatively hypoechoic tubular structure with central echogenic linear structure. The cord gradually tapers to form a conus medullaris at the level between T12 and L1 or L2. Echogenic cauda equina surround the filum terminale that penetrates dural sac at the level of S1-2. Abnormally thickened or echogenic filum terminale can be visualized in case of tight filum terminale or thickened fatty filum with cord tethering. US shows abnormal low position of the spinal cord in spinal dysraphism. Lipomatous tissue connecting the subcutaneous tissue and spinal cord is seen as an echogenic mass extending through the dysraphic spinal canal in lipomyelomeningocele. Hydromyelia is readily visible. Dorsal dermal sinus is visualized as a hyper-or hypoechoic tract extending from the skin surface. A low level of conus medullaris indicates tethered cord with dermal sinus extending to the spinal canal or spinal cord. Sacrococcygeal teratoma, frequently benign cystic mass in the neonate, can be diagnosed with US showing the internal architecture and extent of the mass. Other developmental anomalies of the spinal cord will be discussed.