PURPOSE: The aim of this study was to investigate the relationship between diffuse excessive high signal intensity (DEHSI) in the white matter of the brain MRI and neurodevelopmental abnormalities in VLBW infants. METHODS: The T1- and T2-weighted MR images of the brain around a near term-equivalent age in 167 VLBW infants were evaluated for the white matter lesions. The presence of DEHSI was determined and classified into four grades on the extent of DEHSI. The relationship between the grade of DEHSI and neurodevelopmental abnormalities was investigated in 94 infants who were assessed for neurodevelopmental outcomes by using a neurologic examination and neurodevelopmental assessment (BSID-II) at 18-24 months of corrected age. RESULTS: DEHSI was the most commonly observed white matter lesion (68.3%) in the MR imaging of the brain around a near term-equivalent age. Gestational age and birth weight tended to increase with increasing grade of DEHSI (P=0.060, P=0.001, respectively). There was no significant relationship between the grade of DEHSI and neurodevelopmental outcomes at 18??4 months of corrected age (P>0.05). Periventricular cysts and ventriculomegaly in the brain MRI were significant risk factors for neurodevelopmental abnormalities (P<0.05). CONCLUSION: DEHSI, most commonly seen in the white matter of the brain MRI around a near term-equivalent age in VLBW infants, did not seem to be related to the neurodevelopmental abnormalities at 18-24 months of corrected age.