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In the short time since survival at very low gestational ages became routine for many groups, interest has blossomed into the effects that being born preterm may have on later development for graduates of neonatal intensive care. In the early days of investigation, when most premature births were what we would now call late or moderately preterm, it was unclear what effect being born even 4–8 weeks before term had on long term development. As we have seen, survival at extremely low gestational ages is now progressively improving, and with it our understanding of these late effects. Although all body systems are affected in some way by being born at very low gestations, most research has centred on neurosensory and developmental outcomes and this is the focus for this issue of Seminars in Fetal and Neonatal Medicine. In it we present a dozen articles describing state-of-the-art in our understanding of the long term consequences of very preterm birth for children and adults.