This study examined the relative effectiveness of magnetic resonance (MR) imaging, single photon emission tomography (SPECT) and quantitative magnetic resonance (QMR) imaging in detecting brain abnormalities in 52 traumatically brain injured patients. The relationship between brain abnormalities and neuropsychological and psychological testing results was also investigated. Sixty-two per cent of patients had abnormal clinical MR findings, 57% had abnormal SPECT and 51% had abnormal QMR. Each neuroimaging modality detected brain abnormalities that the other two did not. Neuropsychological and psychological testing indicated significant memory impairments and subjective emotional distress even several years post-injury. Memory and intellectual impairments modestly but significantly correlated with the number of brain abnormalities indicated by all three imaging studies combined, as well as those detected individually by QMR and MR. SPECT abnormalities alone were not correlated with intellectual and memory outcome. Psychological distress was also related to the number of MR abnormalities, with most brain abnormalities being in the frontal areas.