Neonatal chronic lung disease is an important cause of morbidity following premature birth. Surfactant abnormalities, including absence of phosphatidylglycerol and surfactant protein A deficiency, are associated with chronic lung disease. In addition, glycolipids and proteins, inhibitors of surfactant function, are present in the airways of affected patients. To date, there is information regarding the impact of exogenous surfactant on this condition, but preliminary results suggest that even a single dose of a natural surfactant at least temporarily reduces the level of supplementary oxygen requirement. Randomized controlled trials are required to evaluate whether surfactant administration will reduce chronic oxygen dependency and its associated morbidity.