Between 1963 and 1980 we have had experience of 54 patients with gestational choriocarcinoma and 29 are alive, a survival rate of 53.7%. The disease had metastasized to the central nervous system in 15 of these 54 patients, an occurrence rate of cerebral metastases of 27.8%. 13 of these 15 patients have died and 2 are now in a state of remission. Autopsy was performed in 8 cases. The following points are emphasized: cases with the pulmonary disease risk intracranial spread; the serum/cerebrospinal fluid ratio of human chorionic gonadotropin concentrations and computerized tomography are recommended as useful investigations in the diagnosis of CNS disease; decompression surgery in patients with increased intracranial pressure is indispensable; radiotherapy is temporarily effective for brain deposits; powerful systemic chemotherapy using multiple anticancer drugs is suggested to be helpful both in preventing and in treating CNS disease.