Recent evidence supports increased cortical activity and impaired brain connectivity in autism, but the structural correlates of these abnormalities are not yet defined. We performed a voxel based morphometry analysis of brain MRI from patients with autism selected from a group of 103 subjects with pervasive developmental disorders. Twelve male patients with mean age of 12.4 +/- 4 years were compared with 16 matched controls. Patients with autism exhibited increase in gray matter in medial and dorsolateral frontal areas, in the lateral and medial parts of the temporal lobes, in the parietal lobes, cerebellum and claustrum. Patients also showed decrease in frontal, parietal, temporal and occipital white matter. The combination of enlarged cortex and reduced white matter is possibly the structural basis of some symptoms of classic autism.