Neonatal cranial sonograms may at times reveal basal ganglia and thalamic bright echoes. It is believed that these echoes are indicative of vasculitis due to intrauterine infection, in particular with cytomegalovirus (CMV)(Littlewood Teele R. Pediatr Radiol 1998;169:423-427). We reviewed all neonatal cranial sonograms obtained since January 1, 1993 until June 30, 1997, and retrospectively studied all charts of infants in whom echogenic vasculature was found. During that period, it was customary to obtain TORCH studies whenever such ultrasonographic findings were present. We hypothesized that echogenic vessels are not infrequent, and are seldom associated with intrauterine infection. Results: There were a total of 3700 infants in whom a cranial sonogram was obtained (13.7% of all deliveries). In 85 of them,(2.3%), there were echogenic basal ganglia blood vessels. The primary indication for cranial sonograms had been: prematurity (34.7%), small head circumference (9.7%), large head circumference (25%), abnormal neurological findings (15.3%), dysmorphic features (9.7%), or maternal infection (5.5%). Chart review revealed that TORCH studies had been obtained inconsistently by attending physicians. CMV cultures were obtained in 48% of infants and were negative in all but one infant. Herpes serology (IgG followed by IgM if IgG positive) was obtained in 53% of infants and 43% of mothers and was negative in 100% of them. VDRL was obtained in 52% of mothers and negative in 100% of them. Rubella IgG serology was obtained in 53% of mothers and was negative in 20% of them. Toxoplasmosis serology (IgG followed by IgM if IgG positive) was obtained in 41% of mothers and 51% of infants, and was negative in 100% of them. Overall, there was only one infant (≅1%) with confirmed intrauterine infection (CMV). This infant had no clinical signs of congenital infection. Conclusions: Echogenic basal ganglia blood vessels are rare, but not exceptional findings on cranial sonograms. Although TORCH studies were often incomplete, these ultrasonographic findings were seldom associated with intrauterine infection. Speculation: Most cases of echogenic basal ganglia blood vessels are not associated with intrauterine infection. It is probably not cost effective to screen infants with echogenic basal ganglia blood vessels for intrauterine infection, unless there is clinical suspicion of congenital TORCH.