Aim. Obstetric brachial plexus palsy (OBPP) is a common motor impairing condition caused by birth injury. The present study, using voxel- and surface-based morphometry (VBM and SBM), was aimed to examine brain structure of pediatric OBPP patients, to better understand effects of this peripheral condition on early brain development. Methods. Thirty-six T1-weighted images of 18 patients (2-17 years old, mean age=11.3, 8 females) and 18 healthy controls (HC) (2-17 years old, mean age=10.1, 8 females) were collected via Philips Ingenia ElitionX 3.0T scanner. MRI data were processed and analyzed using the Statistical Parametric Mapping (SPM12) toolbox. The results were considered significant if they survived whole-brain family-wise error correction (p < 0.05). Results. Following the VBM analysis, we found that bilateral anterior hippocampus and left cerebellum exterior (Crus I) had smaller volumes of grey matter in patients compared to HC. The SBM analysis showed that right anterior orbital gyrus and bilateral parahippocampal areas had reduced cortical thickness in patients compared to HC. The results of both analyses are presented in the Figure. Conclusions. The structural brain differences in children with OBPP were found in the nodes of multifunctional neural networks, supporting spatial navigation, learning processes, domain-general cognitive functions. This structural reorganization might be linked to the altered environmental adaptation in patients due to their primary motor deficits. Our findings indicate the complex interplay of motor and cognitive outcomes in OBPP and can inform rehabilitation programs for this clinical group.