33 cases of adrenoleukodystrophy in children have been studied. Brain MRI was performed in these patients in order to appreciate the benefits of this technic in patients presenting with the cerebral type of ALD [21]. 12 neurologically asymptomatic patients with the same biochemical disorder were studied. In both groups, MRI is the best imaging modality. In symptomatic patients lesions were clearly demonstrated with excellent clinical correlations. In addition, MRI can depict brain lesions in asymptomatic patients before devastating brain damage occurs. MRI is the essential step before proposing specific treatment to these patients.