From January 1984 to June 1986, 268 consecutive breech presentations in two university hospitals were studied prospectively. Vaginal delivery was attempted in all cases, under expert supervision and electronic monitoring, except in the presence of clear-cut contraindications. For most of the examined parameters no statistically significant differences were found in mortality and morbidity between the vaginally delivered group and the caesarean section group in three birth weight categories. Regarding mortality a relation with the mode of delivery was demonstrable in two cases in the vaginal group and one case in the caesarean section group in the low and very low birth weight category. In the 500-1499 g birth weight category, underestimation of the birth weight during pregnancies led to iatrogenic neonatal death in two cases. Our study shows that the management of breech presentation can be modified in order to stop the increase in caesarean section rate and diminish the degree of variation in operative delivery without affecting the perinatal outcome.