Premature birth or low birthweight contribute to asthma-like respiratory symptoms in childhood but the underlying factors which influence such symptoms have not been thoroughly described. Methods. A modified childhood asthma questionnaire was administered to 149 parents of 7 to 9 year old children who weighed less than 1250 grams at birth (58% response). Results. Parent-reported asthma-like symptoms were prevalent in the cohort (wheezing in the absence of respiratory tract infection, 27.2%; wheezing after exercise, 17.6%; nocturnal cough, 30.4%; any symptom, 42.2%), as was physician diagnosed asthma (27.7%). The risk of asthma-like symptoms and/or physician diagnosis of asthma was not influenced by the infant's sex, maternal smoking during pregnancy, nor early life hospitalization for respiratory infection, passive smoke exposure, or pet exposure. A family history of asthma influences respiratory outcomes, RR=1.5 (1.1-2.1), as does bronchopulmonary dysplasia (BPD), RR=1.5 (1.0-2.1). These relationships persisted after adjusting for recent household pet and passive smoke exposures. There was a relationship between family history of asthma and asthma-like symptoms with symptoms of atopy, RR=2.6 (1.2-5.6) but not with asthma-like symptoms without atopy, RR=0.7 (0.3-1.8). The reverse is true for BPD and asthma-like symptoms with atopy, RR=0.6 (0.3-1.3) and without atopy, RR=2.8 (1.3-5.9). The relative risk with BPD was elevated for infants born at 1001 grams to 1250 grams, RR=1.8 (1.1-3.1) but not for those of lower birthweight, RR= 1.2 (0.7-2.0). Conclusions. BPD and family history of asthma are important risk factors for asthma-like symptoms in 7-9 year old children at very low birthweight. However, these factors may produce differing patterns of respiratory symptoms in childhood. The long term impact of BPD appears to differ in children at extremely low birthweight (≤1000) suggesting differences in the epidemiology of BPD in these infants.Funded by the Foothills Hospital Research and Development Committee