This study was performed to determine the effectiveness of a hospital-based transport team in lowering mortality in newborns. The medical records of 603 outborn infants weighing from 500 to 2500 g and having primary respiratory disorders were reviewed. The infants were admitted to 1 of 3 regional neonatal centers between January 1, 1977 and September 30, 1980. The 2 centers without transport teams admitted 304 outborn infants, of whom 62 (20%) expired by 120 h of age. The center with a transport team admitted 184 team-transported infants and 115 nonteam-transported infants, of whom 38 (13%) expired by 120 h of age. Outborn infants admitted to the hospitals without a neonatal transport team had a 60% (p less than 0.01) greater mortality compared to those admitted to the hospital with a transport team. At the onset of intensive care, the babies transported to the nonteam hospitals had a greater incidence of hypothermia and acidosis which may be related to their increased mortality. We conclude that hospitals without the services of a neonatal transport team may have significantly more deaths among low birth weight infants with respiratory disease than comparable hospitals with neonatal transport teams.