The association of apnea of prematurity with intracranial hemorrhage (ICH) has long been suspected clinically. To test this relationship we studied 22 healthy preterm infants from the first hours of life. The birth weight range was 800 - 1680gms., gestational age range was 28 - 34 wks., and 5′ Apgar score range was 5 - 9. Respiration was monitored by impedance pneumography and continually recorded on pneumotachograph for the first 10 postnatal days. In addition, all infants underwent cranial real time ultrasound scanning 1 - 7 times. Apnea was defined as the cessation of respiration ≥ 15 seconds. Infectious, metabolic, obstructive and thermoregulatory causes for apnea were ruled out. The infants were divided into 2 groups. Group A consisted of 11 infants with > 10 apneic episodes during the first 10 days. Four required assisted ventilation for severe apnea. The remaining seven had a range of 13 - 252 apneic episodes. Group B consisted of 11 infants who had ≤ 10 apneic episodes during the first 10 days. Results: In group A, 10 of the 11 infants demonstrated ICH in contrast to group B where only 1 of the 11 infants showed ICH (P < 0.01). There was no difference between the groups in terms of birth weight, gestational age and Apgar score. Three of the four infants who required assisted ventilation had extensive ICH. In two of these the ICH was found prior to being placed on the respirator. The results confirm the strong association between apnea and ICH in preterm infants. Further studies are necessary to define the causal relationship between ICH and apnea of prematurity. – Supported in part by Ariel Kaare Rosholt Weathers-Lowin Medical Research Foundation.