Accurate nodal staging is important for the management of patients with abdominal and pelvic malignancies. Local and nodal staging using cross-sectional imaging can influence treatment planning. The measurement of nodal size is still the most widely used criteria for discriminating between benign and malignant nodes. However, knowledge of the pathways of nodal spread, the treatment history, and careful analysis of nodal characteristics can improve nodal assessment. An appreciation of normal structures that may simulate nodal disease is also important. The potential for further improving nodal staging accuracy by positron emission tomography and magnetic resonance lymphography is discussed.