National USA mortality statistics for hyaline membrane disease (HMD) and respiratory distress syndrome (RDS) were examined for the years 1968-1973. Detailed data were obtained by computer analysis of magnetic tapes from the National Center for Health Statistics. During the 6-yr interval HMD/RDS was the underlying cause of death in 54,064 infants or 9010 .+-. 560 (mean .+-. SD) infants/yr. Analysis of individual death certificates for 1968 revealed the disease to be a major contributing factor in another 24%. HMD was involved in the demise of nearly 12,000 neonates/yr over this period. This amounts to about 20% of all neonatal deaths. On the basis of mortality rates a trend toward an increased incidence of fatal HMD/RDS was established from 1968-1973. Deaths tend to cluster in the summer months and Jan.-Fed. represent the lowest months of recorded fatalities. Analysis of the age at death, reflecting time course of the disease, revealed identical patterns for 1968-1970. The number of deaths declined exponentially between the 1st and 4th 24-h periods, so that 92% of all deaths occurred by 4 days of age. Boys contributed more prominently to the death totals than girls with ratios from 1.62-1.76. Examination of mortality rates by race suggested that black prematures have a lower incidence of fatal HMD/RDS. In addition to nationwide figures, those of individual states, were compared for 3 yr. Generally, HMD/RDS mortality rates correlated with overall neonatal mortality statistics. Exceptions were observed, such as Illinois, where low rates from the former coexist with relatively high neonatal death rates. These data represent the 1st national mortality statistics for HMD and may prove useful in planning and providing intensive neonatal care.