OBJECTIVE: To study the brain CT findings in premature and term birth children with spastic cerebral palsy. METHODS: Brain CT findings in 88 children (aged 2 months to 7 years) with spastic cerebral palsy were analyzed retrospectively. Of the 88 subjects, 46 cases born preterm and 42, at term. RESULTS: Brain CT showed that abnormal intracranial findings in 69 of 88 cases, many presenting with periventricular leukomalacia(PVL).PVL occurred in 30 preterm patients and in 17 term patients. The incidence of PVL in premature birth patients was significantly higher than that in term birth patients (P<0.05). Seven out of 30 premature birth patients with PVL presented with lateral ventricular enlargement with irregular appearance but none of term birth patients did. The locus of lateral ventricular enlargement and white matter reduction was not different between premature and term birth patients. CONCLUSIONS: PVL seen in brain CT was the main presentation in spastic cerebral palsy. The incidence of PVL in premature birth patients was higher than that in term birth patients and PVL was more severe in premature birth patients.