The hearing of 98 perinatal intensive care survivors with a mean birth weight of 1,540 g was assessed at a mean age of 6 1/2 years. They represented 73% of the long-term survivors with birth weights of 1,800 g or less who had been cared for in our neonatal unit during the three-year period 1971 through 1973. Nine of the 98 infants had sensorineural hearing loss, and 14 had exudative otitis media. During their neonatal period, the infants with hearing loss experienced more frequent apneic attacks, hyperbilirubinemia (serum bilirubin level, greater than 14 mg/dL), and hypothermia compared with their healthy counterparts. There was no evidence that the duration of stay in the incubator or the use of stay in the incubator or the use of ototoxic drugs had affected the hearing of these low-birth-weight infants.