This study shows that besides neonatal withdrawal, there are other important complications during pregnancy and postnatal period that we should be aware of when dealing with the pregnant drug addict. This study is based on a review or 830 cases covering the period from 1972-76.Among the maternal problems, a high incidence of the following conditions were noted: maternal age <20 yrs (17%), meconium stained amniotic fluid (13%), anemia (13%), PROM (12%) and infection (10%). As for infection, venereal disease (57%) urinary tract infection (15%) and hepatitis (6%) were the most common. There was a uniform 3-5% incidence of abruptio placenta, hypertension and toxemia. The Apgar score was <6 at 1 minute in 20% of the infants. Birth weight <2.5 kg occurred in 31%. Of the total infants 19% were premature and 16% were SGA.The postnatal problems that occurred (excluding withdrawal) were: jaundice (14%), infection (11%), aspiration (including meconium) pneumonia (9%), transient tachypnea (7%) and HMD (5%). Congenital malformations were noted in 4% of the infants with the major anomalies involving principally the genitourinary system. A total of 22 (2.6%) infants died. Thirteen (13) were premature with severe HMD and 9 were fullterm (5 with meconium aspiration and 4 with major congenital anomalies).SUMMARY: (1) The lifestyle of the pregnant addict predisposes her and her infant to a nigh incidence of infection, particularly venereal disease, (2) the high incidence of meconium stained fluid and low Apgar score in the infant indicate that fetal withdrawal leading to asphyxia is a serious and not an uncommon complication during the prenatal period, (3) postnatally, despite the high incidence of low birth weight and prematurity, the aspiration syndromes, particularly meconium aspiration, constitute the major pulmonary problem and a leading cause of death in the infant.