The cases of 61 children, consecutively diagnosed during 1986–1990 as having malignant solid tumors (but excluding those with brain tumors and lympho-proliferative diseases), were reviewed. Neurologic complications occurred in 19 (31 %), most often in association with neuroblastomas and sarcomas. Complications observed in order of frequency were: brain metastases in 6 children, spinal cord compression in 5, peripheral or cranial neuropathies in 4, and seizures in the remaining 4. Early recognition of neurologic compromise and rapid initiation of treatment are mandatory in order to prevent permanent disability.