The association of race and gender with different neurological levels of myelomeningocele was studied in 251 patients. Over-all, the white to black ratio was 3.6 and the male to female ratio was 0.86. However, the proportions of whites and females were significantly increased in thoracic-level patients (white to black ratio 13.6, male to female ratio 0.43), whereas the lumbar-level patients had sex and white to black ratios equivalent to the area population. This supports the concept that thoracic-level myelomeningocele has a different pathogenesis from lumbar-level.