Fourteen cases are described in which surface enhancement of the brain or spinal cord was observed on magnetic resonance (MR) scans performed using the paramagnetic intravenous contrast agent gadolinium-DTPA. The sign was seen in cases of meningioma, extradural haematoma, neurosarcoidosis and after surgery and radiation therapy for malignant tumour. This sign is demonstrated on MR with increased sensitivity compared with computed tomography, and is useful in indicating dural attachment of meningiomas. It may also be of value in the presence of meningeal inflammatory changes from a variety of causes.