Of 41 term infants surviving to seven years of age with head circumferences (HC) - 3 SD, 21 were mentally retarded (IQ less than or equal to 70) at seven years. HC - 2 SD was associated with mental retardation in 11 per cent of children. Socio-economic status did not affect mental outcome of children with HC - 3 SD, but higher socio-economic level was associated with better outcome for those with HC - 2 SD or who were normocephalic. Mental retardation in children with HC - 3 SD was more common in children with additional pathology. Of 25 children with no other pathology, one-quarter were mentally retarded at seven years; this was more common in children of normal birthweight. Disproportionate head-to-height ratio did not significantly affect outcome, although short stature was associated with less favourable outcome for those with HC - 2 SD or who were normocephalic.