Aim: To determine school entry status and risk for impaired functioning. Study type/setting: Geographical cohort, Victoria, Australia. Subjects: 218 of 220 long-term survivors born 1985-7 with birthweight <1000 grams or gestation <27 weeks. Outcome measures: Wechsler Preschool and Primary Scale of Intelligence-Revised; Lindsay Infant Rating Scale and Adelaide (Conners) Scale (teacher); Achenbach Child Behaviour Checklist (parent); paediatric examination. Results: Intellectually impaired: 7% (norm 2%), mean IQ score 96. Receiving educational assistance: 13%. In lowest decile on Lindsay Scales: Language 18%, Early Learning 31%, Behaviour 6% and Social Integration 17%, with mean <50th%ile only on Early Learning. Behaviour disordered on ≥1 Adelaide Scale: 25%(norm 32%). Disordered on Achenbach Social Competence and Behaviour Problem Scales: 19% and 16% (norm 10%). Major impairment (retardation/cerebral palsy/vision): 12%, Significant relative risk factors for negative outcomes included 5 minute Apgar <7, seizures or major surgery pre-discharge, abnormal ultrasound, male gender, low work status, English a minor language and non-intact family. Conclusions: School entry deficits were in intelligence, early learning and competence, with neonatal and social risk factors moderate.