Among 19 patients with central nervous system cryptococcosis, (99m)Tc pertechnetate brain scan abnormalities as a result of the disease were encountered in only one patient who had a parietal lobe toruloma. Brain scans were normal in a second patient with a toruloma and in 17 patients with meningitis alone. Two of 4 patients who underwent cisternography had evidence of communicating hydrocephalus and 6 additional patients had radiographic or autopsy evidence of hydrocephalus. The evolution of communicating hydrocephalus may in part account for a poor neurologic response to chemotherapy in cryptococcal meningitis. Cisternography provides a simple method of evaluating this complication.