Objectives: To compare the physical growth, current health status and utilization of health care resources by extremely low birth weight (ELBW) and control (C) adolescents. Design: Cohort study. Growth measures obtained by standard techniques were plotted on Nellhaus and Tanner growth charts. Information regarding current health status/health care utilization was obtained by parent interviews using a validated questionnaire.Setting: Geographically-defined region. Participants: 154/169 (91%) ELBW survivors aged between 12 and 16 years and 125/145 (86%) sociodemographically matched term C. Neurosensory impairments were present in 28% ELBW and 2% C. Results: Growth: Significantly higher proportion of ELBW than C were ≤ 10th centile for weight (31.5% vs 7.4%, p< 0.00001) and height (28% vs 9.8%, p = 0.0004) and < 3rd centile for head circumference (15.6% vs 1.7%, p = 0.0002). Current Health: There were no differences in the incidence of accidents, acute respiratory infections, asthma, renal, cardiac, or hearing problems. Although a higher proportion of ELBW had had surgery since birth (68% vs 36%, p < 0.00001), there was no difference in surgery rates in the last 2 years. There was also no difference in proportion currently taking prescription medications. By parent report, ELBW had a higher prevalence of visual problems (57% vs 21%, p< 0.00001), seizures (7% vs 1%, p = 0.03), developmental delay (26% vs 1%, p < 0.00001), learning disabilities (34% vs 10%, p < 0.00001), hyperactivity (9% vs 2%, p = 0.04), clumsiness (25% vs 1%, p < 0.00001) and emotional problems (16% vs 7%, p = 0.04). Health problems prevented normal participation at school/play in 31% of ELBW and 9% of C (p < 0.0001).Health Care Utilization: During the previous 2 years, there were no differences in rates of hospitalizations, visits to emergency/outpatient clinics or family physicians. However, more ELBW had visited pediatricians(34% vs 14%, p = 0.0002), ophthamalogists (62% vs 34%, p = 0.00001), occupational therapists (7% vs 1%, p = 0.02) and speech therapists (8% vs 0%, p = 0.002). Conclusions: While physical growth continues to be compromised and substantial morbidity remains, there seems to be an improvement in the incidence of acute health problems and utilization of hospital/emergency room resources by ELBW in adolescence. However, ELBW still tend to have higher utilization of specialists and community resources.