A review of 277 newborns with neonatal seizures enrolled in the Collaborative Perinatal Project revealed a mortality of 34.8%. Of the 181 survivors, most followed up to age 7 years, 70% were normal. Thus, despite the fact that seizures are a major indicator of perinatal asphyxia and a predictor of subsequent neurologic deficit, most infants with neonatal seizures who survived did well. Thirteen percent had cerebral palsy, 19% had an IQ less than 70, and 20% had epilepsy. Thirteen percent of survivors had a combination of mental retardation, cerebral palsy, or epilepsy. A low Apgar score, the need for resuscitation after 5 minutes of age, low birth weight, and the early onset of seizures or prolonged seizures correlated with adverse outcome.