Abstract. OBJECTIVE: To present the short- and long-term (20 years) growth and developmental outcomes of four micropremies (birth weight of less than 500 grams). METHOD: Retrospective review of medical records and prospective assessment/interview with patients and their families. RESULTS: One infant was lost at long-term follow-up. The other three showed a quite satisfactory health status and life style in early adulthood. CONCLUSIONS: Despite extreme low birth weight (less than 500 grams) normal outcomes are possible. In the case of micropremies, gestational age appears to be of greater importance than birth weight as well as female gender in the decisionmaking process regarding initiation of resuscitation.