The outcome of very low birth weight (VLBW) infants < 1500 g including those weighing < 1000 g has greatly improved in the last decade.As Caesarean section becomes a safer and more acceptable method of childbirth, it is increasingly performed at earlier stages of gestation.Evidence that Caesarean delivery is effective in reducing intrapartum complications is hard to obtain.We have therefore reviewed our experience in the survival of VLBW infants over a 3 ye3r period.161 infants weighing less than 1500 g were delivered at the obstetric unit and cared for at the Regional Neonatal Intensive Care Unit in Leeds between January 1983 and; December 1985.The hospital survival rate was 63% in 49 infants who weighed 1001-1500 g and 84% in 112 who weighed 1001-1500 g.The survival rate after Caesarean birth was higher than that after vaginal delivtry in the 1001-1500 g group.It is too early to say whether there is a significant difference in the outcome between Caesarean and vaginal births as this requires follow up of these infants at 1 year, 2 years and 5 years.