Although erythema toxicum neonatorum is stated to have been seen at birth,1,2to our knowledge there are no case reports of such an occurrence. The documentation of this phenomenon at birth is a matter of importance from etiologic, diagnostic, and therapeutic considerations. The following is a case report of this condition seen at birth and a discussion of its significance. Report of Case A baby boy was born at the Boston City Hospital on Feb. 6, 1961, of an 18-year-old white primigravida. The mother had been followed in prenatal clinic, the only illness being a "cold," 1 month prior to delivery, with apparent low-grade fever, malaise, and coryza of 3 to 4 days' duration. Labor began at approximately 36 weeks of gestation, and she entered the hospital several hours after rupture of membranes. Labor was rapid and uncomplicated. Spinal anesthesia was given. The presentation was vertex, and delivery