• Two policies of resuscitation at birth were compared: mandatory intubation and stabilization of the airway with continuous positive airway pressure (the electively intubated group), and intubation used according to clinical judgment (selectively intubated group), in infants with a birth weight of 501 to 1,500 g. Of 69 infants electively intubated, 53 (77%) survived; of 96 infants selectively intubated, 49 (51%) survived. Benefits from elective intubation were a higher five-minute Apgar score, less metabolic acidosis within four hours of birth, and fewer ventilatory requirements. Pneumothorax occurred in 33% of the selectively intubated infants and 20% of those electively intubated. Bronchopulmonary dysplasia occurred in 14% of infants electively intubated and 8% of those in the selectively intubated group; retrolental fibroplasia occurred in 16% and 12.2%, respectively. Long-term study showed that laryngeal problems were minimal, occurring in only one of the electively intubated infants. (Am J Dis Child 1982;136:207-210)