Objective: The purpose of this study was to evaluateneonates with meconium stained amniotic fluid and toinvestigate whether pulmonary disease and mortalitywere significantly greater in infants with thickmeconium.Method: We evaluated 278 meconium stained neonatesbetween January 1993 ñ February 1999. Amniotic fluidwas defined as thin (221 neonates) or thick (57neonates) by a pediatrician.Results: Compared to neonates with thin meconium,those with thick meconium appeared to havesignificantly greater rates of acidemia, low  APGARscores at the 1th  and 5th  minutes, more need forresuscitation and higher mortality rate. Meconiumaspiration syndrome and hypoxic ischemicencephalopathy were also significantly higher ininfants with thick meconium.Conclusion: Amniotic fluid with thick meconium maycause more respiratory and other complications inneonates than amniotic fluid with thin meconium.Therefore, tracheal suction is recommended for infantsborn depressed and with thick meconium stainedamniotic fluid.Key words: Meconium stained amniotic fluid, neonate