PURPOSE: This study is to examine the relationship between clinical manifestations and MRI findings of children with CNS symptoms and signs. METHODS: A total of 447 inpatients with CNS symptoms and signs took brain MRI's at the Department of Pediatrics of Chungnam National University Hospital from July 2001 to June 2004. The results were retrospectively evaluated in terms of age, gender, chief complaints, and the findings of MRI and EEG based on the medical records. RESULTS: The overall incidence of abnormal MRI findings was 30.4%, of whom 44.7% were aged from one month to one year. The MRI findings were markedly different between under and over 6 years olds. In the former group, hydrocephalus, periventricular leukomalacia and hemorrhage were common while vascular malformation and brain tumor were more common in the latter group. Periventricular leukomalacia and hydrocephalus were shown to be the most frequent abnormal findings. 42.9% of those with seizures had abnormal MRI findings. Headache was common with 10.5% low incidence rate of abnormalies in MRI. The EEG findings were normal in 33.9% of the patients and there were not any articular correlations between EEG and MRI findings. CONCLUSION: MRI is important in the diagnosis of neurological disorders. However, caution should be taken in selecting patients since the MRI findings were normal in 69.6 % of the children with CNS symptoms and signs. This is the reason why more detailed standards of MRI for CNS manifestations are required.