No agreement exists in the literature regarding the optimal route of delivery for meningomyelocele (MMC) fetuses. Thirty-five MMC cases were retrospective divided into two study groups: vaginal delivery (n = 20); and cesarean delivery (n = 15). The groups were comparable demographically as well as for size and location of the MMC lesion. There were no differences in: 1 and 5 minute Apgar scores; incidence of MMC sac disruption; infants requiring ventriculoperitoneal shunts; infants exhibiting neurogenic bladders, fecal incontinence, orthopedic deformities, seizure disorders or neonatal meningitis. These data suggest neonatal outcome of MMC fetuses is unrelated to route of delivery.