Hematogenous cerebral metastases in children with malignant tumors occurred in 13 (6 percent) of 217 brains examined post mortem. Cerebral hemispheres were involve!d in all but one patient with a cerebellar lesion. Clinical manifestations inclluded headache, vomiting, epilepsy, visual disturbances, and focal neuroloyic deficits. Pulmonary involvement by tumor was present before the onset of central nervous system dysfunction in all cases, which suggests that cerebral metastases were seeded through the arterial bloodstream. In five children, radiation therapy or craniotomy followed by irradiation was associated with survivals of 21/2 to 20 months