The relationship between neuropsychological performance and a childhood history of the hyperkinetic and minimal brain dysfunction syndrome (Hk-MBD) was studied in 60 men alcoholic patients at an alcoholism treatment center. Primary (N = 28) an secondary (N = 32) alcoholics and a matched group of 60 nonalcoholic controls were administered a checklist on the presence of childhood symptoms associated with Hk-MBD. The primary alcoholics reported a significantly higher number of Hk-MBD symptoms than the secondary alcoholics and controls; they also performed significantly more poorly than the other groups on several neuropsychological tests. The secondary alcoholics did not differ significantly from the controls in the number of Hk-MBD symptoms reported or in neuropsychological functioning. Neuropsychological performance did not differ significantly between those with high and low numbers of Hk-MBD symptoms, but in almost all comparisons the direction of differences favored those with low numbers of Hk-MBD symptoms. In general, the results suggest that primary alcoholics might account for most neuropsychological deficits reported in alcoholics and that at least some of these deficits may be present premorbidly.