Meconium aspiration occurred in 66 of 120 infants with meconium-stained liquor admitted to a Neonatal Unit. Four of the 66 infants died, whilst 17 other required ventilatory support. Meconium aspiration syndrome, especially when severe, was more likely if the mother was a smoker, hypertensive, anaemic, Maori or the pregnancy was greater than 42 weeks' gestation. Meconium aspiration was also associated with thick meconium, prolonged labour, late fetal heart decelerations and inadequate suctioning of the airway at birth. Although meconium-stained liquor is a common occurrence in labour, a bad neonatal outcome will only be obviated by vigilant intrapartum care and active suctioning of the infant's airway at birth. Once aspiration has occurred, intensive treatment is often required and sometimes fails.