19 Cases of brainstem glioma were reviewed to evaluate lesion detection by brain imaging and other radiological methods. 99Tc(m) pertechnetate brain imaging was definitely abnormal in only 1 patient. Other techniques proved to be more sensitive and specific. Angiograms were abnormal in 10 of 18 cases while pneumoencephalography demonstrated the lesion in 16 of 19 cases. Brain imaging is not a sensitive diagnostic study in patients with suspected brainstem glioma. A normal brain scan is not useful in excluding this diagnosis and further radiological evaluation is necessary.