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Fifty-five small-for-gestational age neonates were tested for intellectual and neurologic development at 4 to 7 years of age. When infants of mothers who had hypertensive disease (Group A) were compared with those who had no such disease (Group B), it was found that Group A scored generally better on developmental testing than Group B. Within Group B, it was found that heavier neonates of more advanced gestational ages tested higher unlike Group A where lighter neonates delivered earlier tested better, indicating terminal compromise in this group. Major neurologic problems were found more commonly in Group A than Group B, indicating a greater intrapartum vulnerability. It is concluded that in Group A, earlier delivery after the establishment of lung maturity followed by fully monitored delivery would result in better long-term outcome.