To determine which assessments are useful, at what age, in order to identify handicaps in very Iow‐birth‐weight infants, neonatal cerebral ultrasound findings, neurological examinations and the mental scale of the Bayley Infant Scales of Development at 1 and 2 years of age were examined in relation to neurodevelopmental outcome at 3.6 years of age in a cohort of 79 high‐risk very low‐birth‐weight infants. At 3.6 years of age, a minor handicap was found in 9 (11%) and a major handicap in 4 (5%) children. Cerebral palsy was found in 9 (11%) children at 3.6 years of age and could only be diagnosed reliably at 2 years of age. For short‐term follow‐up, as feedback to the neonatalogist, the positive predictive value of intraparenchymal damage, as detected by neonatal cerebral ultrasound, was greater than the positive predictive value of a definitely abnormal neurological examination at 1 year of age. Visual handicaps (n= 4, 5%) and severe hearing deficits (n= 1, 1 %) were all detected in the first year of life. A mental handicap was found in 7 (9%) children. It was impossible to predict mental handicaps for the individual child. Only 35% of the children with a mental delay at 2 years of age had a mental handicap at 3.6 years of age, whereas 35% had a normal cognitive outcome. Pediatricians therefore should be cautious in the interpretation of developmental tcst results in infancy. Long‐term follow‐up is essential for the chil