One hundred sixteen infants with neonatal necrotizing enterocolitis (NEC) have been seen during a 25-year period (1955 through 1979). Prior to 1972, the survival rate was 17%; subsequently, it has been 68%. This increased survival is attributed to (1) improved physiologic care of the critically ill infant, (2) the institution of a standard management protocol, and (3) early diagnosis and treatment. Survival following neonatal NEC is attended by a significant incidence of intestinal stricture (21%); however, physical development has been normal and there have been few long-term gastrointestinal tract problems.