One hundred and twenty-nine children who had indirect serum bilirubin levels over 20 mg/100 ml during the neonatal period were examined at approximately 5 years of age. Only seven children showed sequelae. All had sensorineural hearing impairment, associated in three with aphasia, and in one with mental retardation. Three were mildly athetotic, three had hearing loss alone. Our study would suggest that multiple exchange transfusions are effective in preventing long-term sequaelae due to hyperbilirubinemia.