Necrotizing enterocolitis is“a condition in which there is diffuse or patchy necrosis of the mucosa or submucosa in the small and/or large bowel. The process appears to be localized initially but can spread through the bowel wall to cause perforation, or longitudinally along the wall, leading to the infarction of long segments of the gut.”1This definition, stressing the likelihood of a rapid spread of the disease, is evidence of the necessity of early recognition of its signs and symptoms. Neonatal nurses, functioning as primary caregivers, are in a position to recognize vital changes in an infant's condition. The continuity of neonatal care enables these nurses to assess accurately an infant's“normal”daily functions. Any deviation from this assessment is immediately evident. In necrotizing enterocolitis, as in many other diseases, early recognition of symptoms, followed by accurate diagnosis and early treatment, greatly enhances the survival rate of affected prematures.