A variety of brain structural abnormalities, which can be identified only by qualitative methods, have been shown to correlate with clinical presentation and course of schizophrenia. In the present study, MRI scans of 122 patients with DSM-IV schizophrenia and 81 non-psychiatric controls were evaluated. Among males, the frequency of CNS developmental abnormalities (CDAs) was higher in patients than in controls. Lateral ventricular enlargement (LVE) was more frequent in patients than in controls; when subjects were grouped in three age classes, LVE was more frequent in patients than in controls in the youngest and the oldest age group. Patients with LVE or third VE were older than those without these abnormalities. Schizophrenic patients with LVE or cortical atrophy (CA) had a longer duration of illness than those without these abnormalities. Both patients with LVE and those with third VE had a poorer outcome than those without these abnormalities. CDA findings add to the evidence of a higher frequency of neurodevelopmental abnormalities in male schizophrenic patients. Results concerning LVE suggest that both developmental and degenerative processes underlie this abnormality. The association of LVE and third VE with a poor outcome indicates that qualitative MRI evaluation might be of clinical relevance.