This study disclosed the close correlation between the characteristic developmental change of human cerebral vessels and the occurrence of periventricular leukomalacia (PVL), as judged by anticollagen type 6 immunohistochemical analysis. The earlier appearance of collagen type 6–positive vessels in the deep white matter supports the concept that the medullary vein, a terminal branch of the internal cerebral vein, develops earlier than the cortical and subcortical veins and the perforating artery because the latter was not stained in early gestation. In cases with an old lesion of PVL the distribution of the lesions with abnormal vessels differed with gestation age. These results suggest that its distribution correlates with the development of perforating medullary arteries. Thus a discrepancy between the arteries, revealing slow maturation, and veins, revealing early maturation, in the deep white matter may be an important predisposing factor for PVL. Furthermore, the widespread lesions of PVL may be closely related to the involvement of transcortical tract damage, in terms of specific motor or intellectual disabilities.