Knowledge of current data on survival and morbidity for premature infants is essential for perinatal decision making and accurate counseling of families. Survival and severe morbidity were reviewed for liveborn infants of less than 28 weeks' gestation. Between July 1989 and August 1991, in a cohort of 93 infants with a mean birth weight of 887 gm, survival until hospital discharge to home was 73%. Twenty-eight percent of survivors had either grade 3 or 4 intraventricular hemorrhage or an oxygen requirement at hospital discharge. In the subset of infants of less than 26 weeks' gestation, survival has significantly improved without a rise in morbidity when the data from the study period were compared with data from 1986 through 1988. Survival and morbidity were similar between black and white infants and between girls and boys. These data, along with reports from other tertiary centers, indicate a generalized improvement in the outcome of infants of very low birth weight.