Nationwide surveillance of Rh hemolytic disease of the newborn showed that associated infant mortality decreased from 941 deaths in 1968 to 269 deaths in 1975, or from 2.7 to 0.9/10,000 live births. The incidence of Rh hemolytic disease declined from 45/10,000 total births in 1970 to 21/10,000 in 1975. In 1970, an estimated 16,000 infants were affected, whereas in 1975 the number was 6000. Several state-based Rh disease surveillance programs reported declining mortality and incidence and increasing use of Rh immunoglobulin. Rh immunoglobulin was administered to an estimated 80% of eligible Rh-negative women in 1974, 81% in 1975, and 82% in 1976. More concerted efforts are needed to determine the frequency of maternal sensitization and to identify and correct gaps in postpartum and postabortion use of Rh immunoglobulin.