The pathological findings from seven infants who died with respiratory distress syndrome and had been treated with placebo are compared with seven infants with comparable disease treated with hydrocortisone. Differences in lung, liver, adrenal, thymus, heart and spleen pathology attributable to steroid treatment did not occur between the two groups. A statistically significant association was found between intraventricular hemorrhage and steroid treatment. The pathological findings are consistent with the clinical results in that no beneficial effect occurs when steroids are used after an infant manifests respiratory distress. The possibility that elevated steroid levels increase the likelihood of intraventricular hemorrhage in association with respiratory distress syndrome is raised by these observations, although further information is needed to establish such a relationship.