The operatvie treatment of scoliosis with syringomyelia may pose considerable hazards, yet there is no recommended guides for opreation of scoliosis with syringomyelia. The purpose of this study is to review 6 cases of scoliosis wit, syringomyelia, to determine the necessity of shunt operation and to evaluate the diagnostic significance of MRI. We experinced 6 cases of scoliosis with syringomyelia out of 408 cases of scoliosis which were operated from 1969 to May. 1990. Their age ranged from 12 to 21 years with an average 16.7 years. There were 1 male and 5 females. CT was performed in all cases (2 cases with myelogram) and MRI in 5 cases. The scoliosis angle ranged from 31 to 162 degrees. In 5 cases, abnormal neurologic findings were noted. Following results were obtained 1. In small syrinx, it is not hazardous to perform intrumentation for scoliosis. 2. In large syrinx compressing the cord, it is more recommened to perform instrumentation after shunt operation for syringomyelia. 3. The MRI is the most accurate diagostic tool for syringomyelia.