The aetiology of idiopathic colon perforation in neonates remains unclear. We reviewed seven patients with idiopathic colon perforation from January 1996 to October 2001. Clinical data included age, sex, weight, associated problems, perforationoperation interval, the location of colon perforation, treatment, morbidity, and mortality. All patients were boys. The median age was 34.8 days. Six of the newborn infants were full-term, while one was premature. The aetiology was established in none of the patients. The side of the perforation was transverse colon in three patients, left colonic flexure in two, and sigmoid colon in two patients. After resection of the perforation area, proximal colostomy was performed in four patients and sigmoid colostomy in three. Two patients died. Postoperative wound dehiscence developed in all five patients who survived. Ganglion cells were present in all colonic specimens. In conclusions, many different factors may play a role in developing colon perforation in neonates. However, because of limited number in our series the relative significance of each factor is difficult to assess.