Diagnosis and treatment of severe combined immunodeficiency disease (SCID) is documented in fetuses, term infants, and older children; however, there is very little information on its diagnosis and treatment in premature infants. When Duke University Medical Center's first preterm infant with a known SCID history was delivered, in June 1999, there was no defined protocol for the infant's nursing care. Although many of the guidelines for nursing care of the premature infant population (< or = 36 weeks) apply, there are important considerations for preterm infants with an SCID diagnosis. This article provides background on SCID and identifies those special considerations--namely, multidisciplinary communication, infection prevention, thorough physical assessments, and parental support.