RATIONALE AND OBJECTIVES. TO understand normal bone development, studies in healthy children and adolescents are important. To assess the applicability of tibial quantitative ultrasound measurements (QUS) in children, we performed a study that compared dual-energy x-ray absorptiometry (DXA) of the lumbar spine and whole body with tibial QUS. METHODS. For this study we recruited 146 Dutch children and adolescents, 58 boys (median age, 14.1 years; range, 7.6-23.4 years) and 88 girls (median age, 18.0 years; range, 7.6-23.5 years). Tanner stage, weight, and height were assessed for all participants. Bone mineral density (BMD; g·cm -2) of the whole body and lumbar spine (L 2-L 4) and bone mineral apparent density (BMAD) of the lumbar spine (g·cm -3) were assessed by using the Lunar DPXL. For tibial QUS, the Soundscan compact system was used. RESULTS. Both lumbar as well as whole-body BMD showed a strong, significant correlation with tibial QUS in boys and girls: r(total body boys) = 0.81, r(total body girls) = 0.77, r(lumbar spine boys) = 0.79, and r(lumbar spine girls) = 0.72. Lumbar spine BMAD also showed significant correlations with tibial QUS: r(boys) = 0.63 and r(girls) = 0.63 (for all correlations, P < 0.001). CONCLUSIONS. Our study showing strong, significant correlations between DXA and tibial QUS measurements suggests that tibial QUS is a technique that may be applicable in children and adolescents.