The relative abundance of pulmonary neuroendocrine cells synthesizing gastrin-releasing peptide (GRP) was estimated for normal fetal lungs and hypoplastic lungs. Percentage of bronchiolar epithelial area staining positively with anti-GRP antiserum was computed for each case using a SAMBA 4000 image analyzer. The majority of hypoplastic lungs (10 of 12 cases) showed markedly diminished GRP immunoreactivity, which appeared to vary with etiology. Six cases of pulmonary hypoplasia associated with renal anomalies, three cases associated with hydrops, and one case of diaphragmatic hernia showed an average fivefold reduction in percentage of GRP immunostaining. A case of hypoplasia associated with Werdnig-Hoffmann disease had GRP immunoreactivity similar to that of controls, and GRP expression was markedly elevated (fivefold) in a case of hypoplasia with omphalocele.