Of advances in the field of neonatology, one of the most exciting was the experimental use of exogenous surfactant. Neonatal clinicians and researchers looked to these preparations for specific therapy for hyaline membrane disease and indirect reduction of neonatal mortality and chronic pulmonary disease of prematurity. Published clinical studies of exogenous surfactant were supportive of the anticipated trends in neonatal mortality and morbidity. Up to 1988, however, surfactant therapy was shown to have a more appreciable impact on acute respiratory disease and neonatal mortality than on the rate of bronchopulmonary dysplasia. Unfortunately, published trials reported that even surfactant-treated premature infants developed fatal bronchopulmonary dysplasia.