Lateralization defects such as situs inversus and heterotaxy syndrome present a diagnostic challenge to radiologists because of the overlapping  of clinical and radiological findings.  The majority of patients with lateralization disorders can manifest multiple associeted disturbs  such as congenital heart disease, immune deficiency, intestinal malrotation and respiratory diseases. It is crucial understand and be familiar to radiologic appearance of this conditions in order to establish an individual approach. The knowledge regarding the spectrum of situs anomalies is also important because the unusual anatomy of this patients may result in equivocal radiological interpretation when seen is association with acquired diseases.