SUMMARY The hearing of 111 perinatal intensive care survivors of birthweights 1500 g or less was assessed at a mean age of 64 years (range [4][5][6][7][8][9][10][11][12]. These 111 infants included 86 % of the longterm survivors of this birthweight cared for in the newborn unit of University College Hospital, London, during the years 1966-72. All these infants were nursed in commercially available incubators for periods ranging from 2 to 80 days (mean 37) in which the mean noise threshold was 65 dB. Ten (9 %) had sensory neural hearing losses, one (1 %) infant had a congenital conductive hearing loss, and 21 (19 %) infants had exudative otitis media with a mean loss of 25 dB. Apnoeic attacks in the neonatal period were the most significant predictors of hearing loss in these infants (P<0 .05) and an indirect serum bilirubin level of at least 170 pumol/l (10 mg/100 ml) in the neonatal period had an additive effect (P<0 .05). There was no evidence that ambient noise had affected the hearing of these very low birthweight infants.Reports indicate that the incidence of sensoryneural hearing loss among very low birthweight infants is high (4 to 15-9y%) (Campanelli et al., 1958;McDonald, 1964). Douek et al. (1976) suggested that this might be due to damage of the cochlea by ambient noise from the incubators in which these infants are usually nursed. To support this suggestion they quoted a study by Campanelli et al. (1958) which showed that the mean length of stay in incubators for low birthweight infants with sensory neural loss was significantly longer than the mean for low birthweight infants without hearing loss. There were, however, other important differences between the two groups. In particular, the mean birthweight in children with sensory neural hearing loss was only 981 g, whereas the mean for the children without hearing loss was much greater-1718 g (P<0 05).