We studied the radiological and clinical manifestations of craniopharyngioma in 22 children and 29 adults. The tumours tended to be smaller in adults than in children, and non-calcified, more often solid than cystic and suprasellar than suprasellar-intrasellar. Small tumours were associated with symptoms which had long been overlooked. The size of the tumour did not influence the results of surgery in children, but in adults total removal was more often successful for small tumours. In the children total removal was achieved least often with calcified and suprasellar-intrasellar tumours. Pre-operative skull radiography was abnormal in all except one of the children but in only half of the adults. Sclerosis of the sella floor and erosion of the dorsum sellae are early signs which are easily overlooked.