This review discusses functional and structural brain abnormalities in childhood-onset schizophrenia identified by neuroimaging techniques. Published literature regarding both morphological and functional neuroimaging is discussed, regarding also the diversity of neuroimaging findings which partly reduces their reliability. The findings in early onset schizophrenia are compared with those of adult patients. The results of long-term investigations of structural abnormalities in early onset schizophrenia are given particular attention. The most consistent findings are ventricular enlargement and reduced total brain volume. Further, volumetric changes in the temporal and frontal cortex, thalamus, basal ganglia and limbic system are reported, as are hemispheric asymmetries and, conversely, reduction of normal differences. Findings regarding the corpus callosum and cerebellum are less consistent. In patients whose schizophrenia commenced in early childhood, the differences were generally more marked than in adolescence- or adult-onset schizophrenia. Atrophy of total brain volume was progressive throughout the course of the disorder. It is probable that neuroanatomical cerebral abnormalities present prior to disease onset play an etiopathogenic role in the development of schizophrenia.