Neurologic and radiologic findings in children with well-defined developmental language impairment have rarely been systematically assessed. Children aged 7 to 13 years with developmental language impairment or normal language (controls) underwent language, nonverbal cognitive, motor and neurological assessments, standardized assessment for subtle neurological signs, and magnetic resonance imaging. Nine children with developmental language impairment and 12 controls participated. No focal abnormalities were identified on standard neurological examination. Age and developmental language impairment were independent predictors of neurological subtle signs scores (r(2) = 0.52). Imaging abnormalities were identified in two boys with developmental language impairment and no controls (P = .17). Lesions identified were predicted neither by history nor by neurological examination. Previously unsuspected lesions were identified in almost 25% of children with developmental language impairment. Constraints regarding cooperation and sedation requirements may limit the clinical application of imaging modalities in this population.