The synthesis of acetylcholine, as well as catecholamines, was studied by assaying the activities of choline acetyltransferase (ChA) and tyrosine hydroxylase (TH) in the tumor tissues and the culture cells of human neuroblastoma. In the majority of 20 neuroblastomas of sympathetic origin, both ChA and TH activities were detected at a significantly high level. In the culture cells of five cell lines of human neuroblastoma, ChA activity was high, but TH was negative in four of the lines. However, it was observed that these enzyme activities changed significantly while in the long-term culture. ChA assay is a useful diagnostic test for neuroblastomas that synthesize acetylcholine. Future studies of neuroblastoma should consider cholinergic activity.