Of 1,020 consecutive admissions to a regional neonatal center, 38 infants were admitted following elective delivery in which no medical condition of the mother or fetus had necessitated immediate delivery. Twenty infants had problems that were not primarily the result of elective delivery, developed in 18. Fifteen of these 18 infants were delivered by cesarean section; in none of the mothers had any assessment of fetal maturity or size (other than the menstrual history and physical examination) been made. The infants remained in the hospital for an average of 12.7 days at a median cost of $2,678 per patient. One infant died. In the absence of pressing medical indications and without an objective assessment of fetal maturity, elective delivery remains potentially hazardous.