Spinal dysraphism is common in North America, affecting from one in 500 to one in 1,000 newborns. Although dysraphic conditions vary widely, most can be recognized before any significant neurologic harm occurs. Lesions include simple meningocele, myelomeningocele and tethered spinal cord. Modern imaging techniques delineate the anatomy of the defect, permitting prompt neurosurgical repair, correction of neurologic deficits and prevention of further deterioration.