The authors previously used spectral Doppler imaging to determine optic nerve blood flow velocities in normal children. In the current study, we measured central retinal artery and central retinal vein blood flow velocities by spectral Doppler imaging in 38 healthy children and 18 children with elevated intracranial pressure between ages 4 and 17. We found central retinal artery systolic blood flow velocity was significantly reduced in children with elevated increased intracranial pressure; ANOVA P = .01 (normal children 8.9 cm/s [SD 1.1] versus children with elevated intracranial pressure 7.5 cm/s [SD 1.3]). Central retinal vein maximal blood flow velocity was also significantly reduced in children with elevated intracranial pressure; ANOVA P < .02 (normal children 4.2 cm/s [SD 0.9] versus children with elevated intracranial pressure 3.6 cm/s [SD 0.7]). Spectral Doppler imaging is a noninvasive test well tolerated in children that identifies blood flow velocity changes in elevated intracranial pressure.