OBJECTIVE : The aim of this study was to use dual energy CT technology to maintain or improve image quality in pediatric head CT while simultaneously reducing radiation dose. METHODS : In this retrospective study, helical head CTs performed using a standard head CT protocol were compared to studies performed with a dual energy (DE) protocol. Objective comparison was performed by measuring regions of interest in 11 areas of the brain. Subjective rating for image quality using a Likert scale, was performed by three radiologists. Radiation doses were evaluated using CT dose index and dose length product. RESULTS : Signal-to-noise ratio was, for the most part, not significantly different between the DE and conventional scans. Contrast-to-noise ratio was slightly lower for children over 6 year of age utilizing the dual energy protocol versus the standard protocol. Qualitatively, there was little difference in image quality in patients <6 years old, with the only significant difference in infratentorial noise. However, in patients >6 years of age, infratentorial noise, sharpness and diagnostic acceptability, as well as supratentorial sharpness were all significantly improved by DE CT technique. Radiation exposure as measured by CTDI and DLP was modestly lower with the dual energy protocol in all study populations. CONCLUSIONS : Dual energy CT can be used clinically in pediatric patients to maintain or improve image quality while reducing radiation dose.