Abstract. Objective: To assess neonatal mortality and morbidity after preterm premature rupture of membranes (PPROM) before 24 weeks of gestation. Study design: Retrospective study including live born infants with PPROM before 24 weeks of gestation born at Bonn University Hospital 1994–2002 with a gestational age >23±2 weeks. Results: 69 neonates with PPROMat a median gestational age of 21 weeks were studied. Median latency period to delivery was 53 days, median gestational age at delivery was 27±4 weeks. Overall postnatal survival was 72.5%. In 30.4% chorioamnionitis was diagnosed at birth. 44.9% developed primary sepsis. 69.6% showed respiratory distress syndrome, 14.5% had lung hypoplasia. In 34% of neonates surviving the first month, bronchopulmonary dyplasia was diagnosed. Intraventricular hemorrhage of all grades appeared in 37.7%. Rates of necrotizing enterocolitis (7.2%) and joint contractions (11.6%) were low. Conclusion: Rates of chorioamnionitis, pulmonary and cerebral complications were high in children with PPROM before 24 weeks of gestation.