Ninety-two infants with onset of respiratory distress from birth to 12 hours of life were studied by serial chest roentgenograms. The roentgen findings were compared with clinical and pathological data. Roentgen diagnoses included hyaline membrane disease, pneumonia, fetal aspiration, hyperaeration, pneumothorax, pneumomediastinum, atelectasis, cardiomegaly, and normal chest. Criteria for these diagnoses are discussed. In the infants on whom autopsies were performed, pathologic findings correlated with radiologic diagnosis in 58% of the cases. The roentgen appearance of fine granularity or opacification with air bronchograms were associated with poor prognosis irrespective of the final clinical diagnosis or pulmonary pathology.