One of the major complications following premature birth is the emergence of a respiratory distress syndrome (RDS) that severely affects the health of the premature baby. The application of surfactant has clearly improved the morbidity of neonates with RDS. Little is known about the long-term consequences of neonatal RDS into early childhood. A follow-up study was conducted in 40 children who had been enrolled in a prospective randomized study receiving exogenous surfactant for RDS. 22 had received surfactant (S), 18 were placebo-treated (P). Mean (SD) gestational age had been 28.1 (1.5) and 27.7 (1.3) weeks. At follow-up mean age was 6.63 (0.18) and 6.55 (0.23) years. A complete lung function test (LFT) was obtained in 17/22 surfactant treated and in 8/12 control children. To test bronchital hyperreactivity, a simple running test was performed. Mean TVG was 0.97 (0.18) and 0.90 (0.20) L. mean Raw(exp) was 1.04 (0.26) and 1.15 (0.53) kPa/L/s, and mean FEF 25 was 0.76(0.25) and 0.79 (0.35) L/s for surfactant and placebo group. There was no difference with regard to Raw,FEV 1, and PEF following the running challenge between the two groups. In conclusion, at early school-age LFT was normal and no difference in baseline-parameters was detected in S and P. However, lack of cooperation during LFT makes further follow-up studies necessary at an older age.