diff --git a/docs/using.md b/docs/using.md
index ce3a4c08..816bd75c 100644
--- a/docs/using.md
+++ b/docs/using.md
@@ -286,6 +286,14 @@ print(node[0])
 node[0].next_sibling
 ```
 
+Use `node.to_tokens()` to recover the linear token stream after modifying the
+tree's `children`, including those of inline and image nodes. This reuses the
+original token objects and updates their child lists to match the tree.
+The child lists are replaced in place, so the token stream the tree was built
+from sees the same edits. Another tree built from the same tokens keeps its own
+nodes, and its `to_tokens()` writes its own children back.
+Build the tree from `copy.deepcopy(tokens)` to avoid sharing.
+
 ## Renderers
 
 +++
diff --git a/markdown_it/tree.py b/markdown_it/tree.py
index ebe00d23..dab29ae1 100644
--- a/markdown_it/tree.py
+++ b/markdown_it/tree.py
@@ -91,13 +91,29 @@ def __getitem__(self, item: int | slice) -> Self | list[Self]:
         return self.children[item]
 
     def to_tokens(self) -> list[Token]:
-        """Recover the linear token stream."""
+        """Recover the linear token stream, including changes to the tree.
+
+        The original tokens are reused, with their child lists updated to match
+        the tree.
+
+        The ``children`` of inline and image tokens are replaced in place.
+        These ``Token`` objects are shared with the token stream the tree was
+        built from, so that stream sees the edits too.
+        Another tree built from the same tokens keeps its own nodes,
+        and its ``to_tokens()`` writes its own children back.
+        Build the tree from ``copy.deepcopy(tokens)`` to avoid sharing.
+        """
 
         def recursive_collect_tokens(node: Self, token_list: list[Token]) -> None:
             if node.type == "root":
                 for child in node.children:
                     recursive_collect_tokens(child, token_list)
             elif node.token:
+                if node.token.children is not None:
+                    children: list[Token] = []
+                    for child in node.children:
+                        recursive_collect_tokens(child, children)
+                    node.token.children = children
                 token_list.append(node.token)
             else:
                 assert node.nester_tokens
diff --git a/tests/test_tree.py b/tests/test_tree.py
index 36bd0b67..b06a80ba 100644
--- a/tests/test_tree.py
+++ b/tests/test_tree.py
@@ -1,3 +1,5 @@
+import pytest
+
 from markdown_it import MarkdownIt
 from markdown_it.tree import SyntaxTreeNode
 
@@ -10,8 +12,94 @@
 
 def test_tree_to_tokens_conversion():
     tokens = MarkdownIt().parse(EXAMPLE_MARKDOWN)
+    serialized_tokens = [token.as_dict() for token in tokens]
     tokens_after_roundtrip = SyntaxTreeNode(tokens).to_tokens()
     assert tokens == tokens_after_roundtrip
+    assert [token.as_dict() for token in tokens_after_roundtrip] == serialized_tokens
+    assert all(
+        before is after
+        for before, after in zip(tokens, tokens_after_roundtrip, strict=True)
+    )
+
+
+def _node_at(tree, path):
+    node = tree
+    for index in path:
+        node = node[index]
+    return node
+
+
+@pytest.mark.parametrize(
+    "source,path,expected",
+    [
+        ("one\n\ntwo", (), "<p>two</p>\n<p>one</p>\n"),
+        (
+            "before *nested* after",
+            (0, 0),
+            "<p> after<em>nested</em>before </p>\n",
+        ),
+        (
+            "![before *nested* after](image.png)",
+            (0, 0, 0),
+            '<p><img src="image.png" alt=" afternestedbefore " /></p>\n',
+        ),
+    ],
+    ids=["blocks", "inline", "image"],
+)
+def test_tree_to_tokens_reordered_children(source, path, expected):
+    md = MarkdownIt()
+    tree = SyntaxTreeNode(md.parse(source))
+    _node_at(tree, path).children.reverse()
+
+    assert md.renderer.render(tree.to_tokens(), md.options, {}) == expected
+
+
+@pytest.mark.parametrize(
+    "source,path,expected",
+    [
+        ("before *nested* after", (0, 0), "<p></p>\n"),
+        ("before *nested* after", (0, 0, 1), "<p>before <em></em> after</p>\n"),
+        (
+            "![old alt](image.png)",
+            (0, 0, 0),
+            '<p><img src="image.png" alt="" /></p>\n',
+        ),
+    ],
+    ids=["inline", "nested-inline", "image"],
+)
+def test_tree_to_tokens_cleared_children(source, path, expected):
+    md = MarkdownIt()
+    tree = SyntaxTreeNode(md.parse(source))
+    _node_at(tree, path).children.clear()
+
+    assert md.renderer.render(tree.to_tokens(), md.options, {}) == expected
+
+
+def test_tree_to_tokens_replaced_empty_inline_children():
+    md = MarkdownIt()
+    tree = SyntaxTreeNode(md.parseInline(""))
+    replacement = SyntaxTreeNode(md.parseInline("*new*"))
+    tree[0].children = replacement[0].children
+
+    assert md.renderer.render(tree.to_tokens(), md.options, {}) == "<em>new</em>"
+
+
+def test_tree_to_tokens_updates_original_tokens():
+    """Inline child edits are written in place on the shared tokens.
+
+    This pins the documented behaviour of ``to_tokens``: the token stream the
+    tree was built from sees the edit as well.
+    """
+    md = MarkdownIt()
+    tokens = md.parse("before *nested* after")
+    tree = SyntaxTreeNode(tokens)
+    tree[0][0].children.clear()
+
+    tree.to_tokens()
+
+    assert tokens[1].type == "inline"
+    assert tokens[1].children == []
+    assert md.renderer.render(tokens, md.options, {}) == "<p></p>\n"
 
 
 def test_property_passthrough():