Preimplantation human embryos are characterized by various degrees of cytoplasmic fragmentation, and a high incidence of developmental arrest before the blastocyst stage. This review examines the current morphological and biochemical evidence that apoptosis plays a role in early human development and embryonic loss. Embryos examined 24 h or more after arrest often show characteristic features of apoptosis including cytoplasmic, nuclear and DNA fragmentation. In contrast, embryos of good morphology that appear to be developing normally show no evidence of apoptosis before compaction. However, at the morula and blastocyst stages, scattered cells with fragmented nuclei and DNA characteristic of cells undergoing apoptosis are common features. Apoptosis may result from suboptimal culture conditions, or may be involved in the elimination of abnormal cells. However, the causes, role and regulation of apoptosis in the human preimplantation embryo remain to be determined.