During a 2-month period, 78 neonates admitted to our Special Care Unit (SCU) were screened for hematuria by dipstick and microscopic examination within 48 hours of admission. 63 healthy full-term neonates were similarly screened. Hematuria was not found in any healthy full-term neonate but was present in 62% of those in the SCU. None with hematuria had enlargement of the kidney by abdominal palpation, abnormal genitalia or progressed to have significant elevation of BP, proteinuria, BUN or serum creatinine. The hematuria cleared within 2 weeks of birth in all patients. Among the babies requiring special care, those with hematuria had lower gestational age (GA), lower birth weight (BW) and lower Apgar scores at 1 and 5 minutes (AS1 and AS5). All babies GA ≤ 30 weeks or BW ≤ 1500 grams (18% of SCU admissions) had microscopic hematuria. We conclude that transient microscopic hematuria is common among neonates requiring special care, and that it appears to be of no consequence in the absence of other evidence of renal or urologic disease.