Two cases of pediatric thoracic actinomycosis are presented. A review of the English literature revealed forty-six additional cases in the last 25 years. The mean age of diagnosis was 10 years. The most common presentation was a mass associated with weight loss, fever, and cough. Actinomyces israelii was the most common causative organism. Prognosis was generally excellent after long-term therapy with penicillin.