Picture books can influence how children perceive those from backgrounds and cultures different from their own. Studies have been conducted examining how the text of children's literature portrays multicultural characters or characters with disabilities. However, few have looked specifically at the portrayal of characters through illustrations, despite growing understanding of the importance that illustrations play in text comprehension. Fewer still have analyzed children's literature for depictions of deaf characters and characteristics of Deaf culture. One recent study examined children's picture books for portrayals of deaf individuals in the text; however, examining illustrations may provide additional information for both hearing and d/Deaf (For the purpose of this paper, capital "D" Deaf refers to people who are recognized part of the Deaf community; "d" deaf refers to the inability to hear or people unable to hear; d/D includes both populations.) readers about deafness and the Deaf population. In addition, while illustrations are important for all young readers, they may be particularly important for d/Deaf readers who are by nature visual learners. Therefore, the purpose of this study was to conduct a content analysis of illustrations in 20 picture books targeted to ages 4 to 8 years for messages linked to pathological and cultural models of deafness. In addition, results were compared to previous analyses of the text in the picture books. Results indicated that the illustrations do not represent deaf characters from a cultural perspective. Instead, similar to the text, illustrations present deaf characters more frequently as having a pathological condition or disability, that should be fixed through medical interventions in order to fit into a hearing world.