Perinatal networks, antenatal administration of glucosteroids, postnatal administration of surfactant, and new techniques for mechanical ventilation, have considerably improved the prognosis of extremely preterm infants. Such recent progress in perinatology had enabled neonatologists to provide intensive care for infants born after 24 and 28 weeks of gestation. This practice raises serious medical and ethical issues. The optimal mode of delivery of such newborns is not well established mainly because available studies are retrospective and subjected to biases. Moreover, perinatologists are implicated in the continuing discussion on ethical issues that modify clinical practices.