Regionalization of perinatal care and the efficient provision of effective and safe interhospital transport of premature and critically ill newborn infants have evolved over two decades. Antenatal transfer of the high-risk fetus to a tertiary perinatal center is optimal but not always achievable. Neonatal transport is a complex, highly organized, dynamic process that is still evolving. Resuscitation and stabilization, supported by the tertiary perinatal care center, commence within the environment of the community hospital. Current developments improving communication with community physicians and the availability of outreach education programs assist these processes. Transport remains a sophisticated, highly technological procedure that requires extremely skilled personnel. The application of new ventilatory techniques and other strategies may enable the safer transport of critically ill newborn infants. Regionalization of perinatal care has been achieved in many areas, but its viability is threatened by the current competitive health care environment. The neonatal transport team is likely to be the most potent stimulus for the development of the “perinatal partnership” during the current decade.