Pathologists have recognized since late in the 19th century that pneumonia was responsible for the deaths of many newborn infants.1Since many who died were stillborn or died within the first few hours or days of life, it was obvious that a certain proportion must have acquired pneumonia in utero. Pediatricians have virtually ignored this observation. Pneumonia is seldom diagnosed; indeed, it is rarely considered as a possibility in the differential diagnosis of respiratory illness in the early neonatal period. In this report we shall attempt to demonstrate that this condition is recognizable, given a high enough index of suspicion, and that it is not invariably fatal. In addition, we suggest that some cases are preventable and that vigorous treatment may be lifesaving. There is a considerable percentage of stillborn and newborn infants in whom evidence of inflammation of the lungs has been discovered in large series of consecutive