PPROM is frequently associated with pulmonary hypoplasia. Some infants, however, do survive and our aim was to determine the incidence of impaired lung growth and its relationship to chronic respiratory morbidity in these children. 53 pregnancies complicated by PPROM before 32 weeks gestation were studied. Of these, there were 2 termination, 2 spontaneous abortions, 1 utrauterine death, 22 neonatal deaths, and 26 were discharged home. Of these 26, 5 were lost to follow up. The remaining 21 had a mean gestation of 32 weeks (range 25-41), mean rupture of membranes (ROM) at 24 weeks (range 15-32) and mean duration of ROM of 8 weeks (range 1-20). The mean length of follow up was 15 months (range 6-22). Only 5 infants (4 of whom were ventilated) had recurrent respiratory problems. These infants were born more prematurely than the asymptomatic infants (p<0.05). Only 3 children required hospital admission for chest related disorders and all 3 suffered with recurrent respiratory symptoms. No relationship was found between either recurrent symptoms or hospital admission and duration or length of membrane rupture. At one year, abnormal lung volumes were only found in the symptomatic ventilated infants, except for 2 infants who had very early onset and prolonged duration of ROM. We conclude that chronic respiratory morbidity following PPROM relates to the gestation at birth and neonatal ventilation and only in extreme cases to the duration and onset of membrane rupture.