Bronchoscopy is necessitated in few instances of respiratory distress in the newborn in the first few hours of life.1 Most cases of acute respiratory distress in newborn infants are of three groups: In the first group are cases in which the condition is of central nervous system origin, in which endoscopy is of little value and may be harmful. In the second, and largest, group are those in which the cause of the distress is obstructive in nature—usually aspirated mucus, meconium, blood or vernix caseosa. In the second group, aspiration of the offending foreign material is immediately indicated and is often lifesaving. The third group is the smallest of the three and includes the occasional rare case in which anomalies of the respiratory tract are found. There were only two in the present series of 79 cases. It is this last small group only that requires bronchoscopy.