Previous studies of school-age children born prior to term indicate that they often have visual acuity that is slightly poorer than normal. However, visual acuity results for preschool-age preterm children have not been reported. In this study, we used the operant preferential looking procedure to measure the visual acuities of 23 3- to 4-year-old preterm children. The results indicated that, although many of the children had acuities within the normal range, the average acuity of the preterm children was slightly poorer than that of full-term children of the same age, even when children with significant refractive errors were eliminated from the sample. Neither birthweight, gestational age at birth, nor the presence of respiratory distress syndrome during infancy were predictive of later visual acuity. However, preferential looking acuity screening at 4 months corrected age did have some predictive value, in that 3 of the 4 infants who failed to complete testing at 4 months showed poor performance at 3 to 4 years of age.