BACKGROUND: Oculo-orbital tumors are frequently encountered pathologies and late diagnosis results in high morbidity and mortality in developing countries. This study aims to assess the computed tomography and magnetic resonance imaging patterns of pediatric oculo-orbital tumors with particular emphasis on retinoblastoma and compare agreement between imaging and histopathology diagnosis.METHODS:  A retrospective analysis of 101 pediatric patients with oculo-orbital lesions from February 2017 to January 2020 at Tikur Anbessa Specialized Hospital oncology center.  Medical records were reviewed for clinical data, history, physical examination, pre-treatment eye exam under anesthesia (EUA), computed tomography (CT) magnetic resonance imaging (MRI) and histopathology reports. The agreement between imaging and histopathology diagnosis was analyzed.RESULTS: Malignant oculo-orbital tumors represented 97 (96.1%) cases.  Age group 2-5 years had 56 (55.4%) cases of oculo-orbital tumors. Retinoblastoma accounted for 78 (77.2%) followed by rhabdomyosarcoma in 8 (7.9%) patients. The primary patient complaint was proptosis in 78 (77.2%) followed by leukocoria in 16 (15.8%). In 88 (89.7%) cases, there was agreement between imaging and histologic findings with 72 out of the 75 histopathology confirmed cases of retinoblastoma showing an agreement.  Retinoblastoma patients presented at an advanced stage with orbital and intracranial extension.Conclusions: In conclusion, patients with oculo-orbital tumors presented with advanced stage of disease. Excellent imaging and histopathology agreement was demonstrated.KEYWORDS: CT, Histopathology, MRI, oculo-orbital, Retinoblastoma