A retrospective study of 70 patients with preterm premature rupture of membranes before 26 weeks of gestation was performed. The purpose of this study was to examine the perinatal outcome and the potential maternal and neonatal morbidity associated with this obstetric condition. The mean gestational age at diagnosis of rupture of membranes was 23.7 weeks. The latency period ranged from 24 hours to 60 days with the mean being 12 days. There was no correlation between gestational age at rupture of membranes and latency period. Seventy-one infants were delivered. The perinatal survival was 63%. Sixty-eight percent of the survivors had normal neurological and physical development at 1-year follow-up. Amnionitis developed in 43% of patients. The incidence of respiratory distress syndrome in the neonates was 52%. Betamethasone did not appear to reduce this incidence. The perinatal survival in patients with midtrimester rupture of membranes appears to be improving with the advancements in neonatal care of the extremely premature infant.