The pervasive problem of cocaine addiction among pregnant and postpartum women continues. This group of women currently represents 24% of those who deliver their babies at the Medical College of Pennsylvania, the site of data collection for this study. The potential deleterious effect of this exposure remains largely unknown. To date much of the research has addressed the term infant. This study examines at six months adjusted age, the developmental effects of in utero cocaine exposure on the infant born prematurely. A group of infants born prematurely and exposed to cocaine in utero (n = 9) were compared with a control group of infants born prematurely whose mothers did not use cocaine during their pregnancies (n = 17).The Peabody Developmental Motor Scales (PDMS) and the Chandler Movement Assessment of Infants—Screening Tool (CMAI-ST) were administered to all infants at six-months adjusted age. The PDMS is a norm-referenced quantitative measure whereas the CMAI-ST is a criterion-referenced assessment that provides both quantitative and qualitative measures of motor development.The findings of this study demonstrate no significant differences on the Developmental Motor Quotient (DMQ) generated from the gross motor portion of the PDMS between infants born prematurely and exposed to cocaine and infants not exposed to cocaine. Additional analysis showed infants in the cocaine-exposed group had a mean DMQ score greater than one standard deviation below the PDMS mean of 100. Infants in the nonexposed group had a group DMQ mean less than one standard deviation below the mean. A significant difference in CMAI-ST total risk scores was demonstrated between the two groups, with infants exposed to cocaine exhibiting higher total risk scores. Significant differences were noted in the individual test areas of muscle tone, primitive reflexes, and volitional movement, with infants exposed to cocaine faring worse. Findings of this study suggest that infants who are exposed to cocaine in utero should be screened using both qualitative and standardized quantitative assessment tools as part of their routine pediatrie care, and they should also be monitored for developmental delay as appropriate. The importance of assessing motor development quantitatively and qualitatively has been demonstrated by this research.