Summary: The Jebsen-Taylor hand function test was performed on 143 patients with myelomeningocele, 8-35 years of age. Compared with normal individuals, matched for sex and age, patients with myelomeningocele demonstrated impaired hand function. Thoracic level and high lumbar level patients exhibited poorer hand function than low lumbar and sacral level patients. Patients who required more than three shunt operations for continued control of hydrocephalus were more likely to have abnormal hand function. Awareness of such deficiencies should enable orthopedic surgeons, therapists, and parents to establish realistic functional expectations and management aims for these children