During the last decade, there has been a marked increase in the survival of the micropremic —:infants with birth weights less than 800 g, which is a testimony to the advances in perinatal medicine. However, with this survival has come significant morbidity. This article reviews the outcome of these tiny infants, some of the consequences for their families, and the implications for primary care providers. Many of these infants have growth delays and many medical problems despite adequate nutrition and general care. Also, while only about 10% to 20% of the survivors have significant neurodevelopmental problems, almost 60% have some disability. Significant numbers of these children—including those without major neurologic disturbances—have disorders of sensory integration and learning disabilities that significantly affect their school and psychosocial functioning. Moreover, these disabilities are stressful for these infants' families. Taking these findings into consideration, it is strongly suggested that practitioners take a proactive approach to the management of these children with close monitoring and assessment that hopefully will lead to the early identification of difficulties and intervention. With this strategy, it is believed that many of these children's difficulties can be ameliorated, leading to a more positive outcome for the child and family.