Retrospective assessment was performed of the minimum apparent diffusion coefficient (minADC) together with quantitative assessment of the histopathological features of resected tumour tissue and the Ki-67 labelling index (LI) for predicting pineal parenchymal tumour (PPT) grade. Magnetic resonance images of tumours from 26 male and female patients (mean age 27.7 years) with pathologically confirmed PPTs, comprising 10 pineocytomas (PCs), seven pineal parenchymal tumours of intermediate differentiation (PPTIDs) and nine pineoblastomas (PBs), were reviewed retrospectively. Using ADC maps derived from isotropic diffusion-weighted images, the minADC value of each tumour was determined postoperatively from several regions of interest defined in the tumour, excluding cystic, necrotic, haemorrhagic or calcified components. Surgical intervention was undertaken in all cases. The Ki-67 LI was measured in surgical specimens. Mean minADC and Ki-67 LI showed significant differences among PCs, PPTIDs and PBs, and minADC was negatively correlated with Ki-67 LI. It is concluded that the minADC of PPTs provide useful additional information when predicting tumour grading.