Ninety-four infants weighing less than 2 kg were screened for intracranial abnormalities on the third and seventh days after birth using high-resolution real-time ultrasound. An overall abnormality rate of 37% was documented, with intracranial hemorrhage making up 83% of the abnormalities. Infants with abnormalities were then followed up for one to 12 months. Reversion to a normal ultrasound appearance was unlikely on follow-up in patients with lateral ventricular dilatation on the day-seven scan, whether or not dilatation was accompanied by intracranial hemorrhage. The ultrasound appearance became normal in 93% of the infants with intracranial hemorrhage but without dilated ventricles on their day-seven scan. The authors conclude that ultrasound is an efficient screening method for intracranial abnormalities in low birth weight infants.