Fifty infants with hydrocephalus and myelomeningocele were treated comprehensively by a team of specialists. Patients were evaluated at death or the first birthday, whichever occurred first. Twenty patients died, 13 from bacterial infection. Thirteen of the survivors were classified as noncompetitive, that is, were thought to have a poor prognosis based on a developmental quotient of less than 80. Seventeen patients were judged competitive; in each case the latest developmental quotient was more than 79 and the urinary tract was not irreversibly decompensated. Developmental quotient was based on motor development, adaptive behavior, language development, and personal-social development. This report is a progress report in a longitudinal study. In comparison with a previously surveyed group, the results seem encouraging: current data from 39 older patients followed 6 to 13 years shows 2 competitive survivors, 11 noncom-petitive survivors, and 26 deaths.