In a controlled series evaluation of early administration of intravenous glucose and sodium bicarbonate, the mortality rate among 35 treated premature infants with respiratory distress syndrome was 17%, while among 35 controls it was 37% (p = 0.06). The mortality rate was similarly reduced among the total number of premature infants who have been treated by the author for this condition over the past five years: 24/118, or 20%, mortality with early intravenous therapy versus 38/94, or 42%, mortality with conventional therapy (p<0.01). Intravenous therapy had little or no effect in premature infants weighing less than 1,500 gm. With this therapy for respiratory distress syndrome, the mortality rate among 736 premature infants consecutively delivered at two hospitals was exceptionally low—5.7% of infants weighing 1,001 to 2,500 gm. There was no evidence that the therapy operated to reduce mortality by lessening the respiratory distress process, which was equally severe among treated and untreated infants. The fluids administered to these infants did not produce heart failure or fluid overload. Sudden collapse which may have been due to reactive hypoglycemia sometimes resulted, however, when intravenous therapy was stopped before the infant was receiving adequate enteral feedings. It is concluded that early administration of intravenous glucose and sodium bicarbonate to premature infants with respiratory distress (hyaline membrane) syndrome can reduce the mortality rate by two-thirds among those who weigh more than 1,500 gm.