Direct extension and hematogenous metastasis of primary non-CNS malignant tumors to the CNS are rare complications in children. The authors analyzed the incidence and outcome of these complications in Hungary. During a 14-year period between 1989 and 2002, 406 patients younger than 18 years were studied at Semmelweis University, Second Department of Pediatrics, in Budapest. Among the 406 patients with non-CNS solid tumors, nine hematogenous metastases and five direct tumor extensions to the CNS occurred. Primary tumors included rhabdomyosarcoma, neuroblastoma, tumors of the Ewing sarcoma family, non-Hodgkin lymphoma, and malignant chordoma. Mean interval between the initial diagnosis and the diagnosis of CNS involvement was 11.4 months. Despite intensive treatment, the mean survival after detection of CNS involvement was 10.4 months. The frequency of CNS involvement in non-CNS tumors is low, with a very poor survival.