There are few studies in the pediatric population regarding the use of magnetic resonance venography to rule out cerebral venous sinus thrombosis in patients presenting with signs and symptoms of idiopathic intracranial hypertension. The purpose of this study was to compare the clinical characteristics of children with presumed idiopathic intracranial hypertension who did and did not undergo venography during their evaluation at a single children's hospital. The authors found that 45 of 68 (66%) patients underwent magnetic resonance venography. Five of 45 (11%) venography studies revealed a thrombosis. There were no significant clinical differences within patients based on the completion of venography or the presence of thrombosis. Larger studies are needed to identify risk factors for thrombosis in children with presumed idiopathic intracranial hypertension, as well as factors influencing physician decision making in the use of magnetic resonance venography in this evaluation.