Between 1961 and 1970, 177 survivors of hyaline membrane disease have been followed clinically and roentgenologically for a minimum of three years to determine the long-term pulmonary outcome. Of these, 153 have been seen for at least six years and 61, for 11 years or more. A total of 175 batteries of pulmonary function tests have been performed on 129 children at age 7 and/or 11 years, Final roentgenograms showed fibrosis in 12 instances, and these changes were positively correlated with the severity of the initial disease, the use of a positive pressure respirator (but not negative pressure respirator), time on the respirator, and length of time in O2, but not high O2 concentrations. Residual symptoms in the first years of life were also correlated with positive pressure respirator use, length of use, and with secondary infection. Pulmonary function tests showed minimal abnormalities in 12 children when last seen. None of these children had a history of exercise intolerance or chronic respiratory symptoms. The ultimate pulmonary history of this population of patients is unknown, but overt childhood lung disease following hyaline membrane disease is not a frequent occurrence.