Thirty-one of 32 pineal and related tumors were diagnosed by computed tomography (CT). There were 7 germinomas, 4 primary pineal tumors, 4 embryonal cell carcinomas, one teratoma, one epidermoid, one primitive neuroectodermal tumor, 8 astrocytomas and 6 lipomas. Histologic confirmation was obtained in 22. The CT characteristics allow differentiation of benign tumors such as teratomas and epidermoids from malignant germinal lesions such as germinoma and embryonal cell carcinoma. Abnormal calcification occurs most frequently in the primary pineal tumors, pineoblastoma and pineocytoma. The CT characteristics and consideration of the patient's age and sex often lead to histologic prediction and better treatment planning.