Bronchopulmonary dysplasia (BPD) is both a significant clinical problem associated with neonatal intensive care and a sign of the success of that care. It can best be understood in the context of the historical continuum of improving survivability for prematurely born infants. Some of the adolescents and young adults surviving with BPD will have late pulmonary dysfunction. All the molecular-biologic and technologic approaches used in the past 25 years have not clearly reduced the overall incidence of BPD. It would seem time to approach seriously the problem of decreasing the overall incidence of BPD by decreasing the incidence of premature birth in the United States.