Examined the relation of neonatal cranial ultrasonography abnormalities to later psychiatric disorder in 564 low birth weight children (aged 5.2–8.7 yrs). Psychiatric diagnoses were assessed by means of the Diagnostic Interview Schedule for Children–Parent version, and detailed information was collected on other predictors and outcomes. Results show that 454 Ss had no cranial abnormalities, 78 had germinal matrix hemorrhage (GMH) and/or intraventricular hemorrhage (IVH), and 32 had a parenchymal lesion (PL) or ventricular enlargement (VE). 22% of the Ss had at least 1 psychiatric disorder, the most common being attention deficit hyperactivity disorder (ADHD). Isolated GMH/IVH did not increase risk for psychiatric disorder at age 6 yrs, while PL/VE increased the risk of having at least 1 psychiatric disorder by 4-fold. Among the other predictors, maternal smoking elevated risk of psychiatric disorder. Male sex and proximal, but not distal, social disadvantage predicted the risk of any disorder and ADHD.