Congenital megacolon, known as Hirschsprung's disease, is potentially lethal cogenital anomaly due todangerous complications if diagnosis and treatment are delayed. Early diagnosis is important because immediatesuccessful surgical contol reduces mortality and morbidity of this infantile diseases and barium enema study isthe most important diagnostic tool. Authors analyzed clinical and radiological findings of 41 cases of confirmedcongenital megacolon during Dec. 1978 to July 1980 at Seoul National University Hospital. Majority of the casesare male and below one year old. Majority of the cases represent abdominal distention, chronic constipationrelieved by enema, no passage of meconium within 24 hrs. after birth, vomitting, defication difficulty andemaciation. Cases of showing exudative enteropathy complaints diarrhea, dehydration and melena. In simple abdomenfilm, 25 cases show moderate degree of abdominal distention and 10 cases show markedly distended abdomen. Mostfrequent segmental pattern is type C (26.8%) and type B is the next (24.4%), and type A ' occupy 14.6%. There areone case of jejunal aganglionosis and two cases of total colonic aganglionosis. Most frequent shape of transitionzone is type II (34%), and type VI is the next (24%) and type IV occupy 17%. In 82% of the cases show hypertrophyof bowel wall of dilated segment, and 85% of above cases show findings of exudative enteropathy. In 73% of thecases show exudative enteropathy. Almost of cases showing markedly distended abdomen, also have moderate to markeddegree of hypertrophy of bowel wall and findings of exudative enteropathy. Three cases were taken 24hrs, delayfilm, show retention of the main bulk of barium.