Among 125 neonatal deaths which occurred between 1985 and 1987 in a neonatal intensive care unit, 90 autopsies (72%) were performed. Autopsies in 58 cases (64%) confirmed antemortem conclusions. In 26 cases (28%) post-mortem examination rectified antemortem findings whereas in 6 cases (6.6%) it did not contribute to a better understanding of the cause of death. When there was a risk of an heritable disease and genetic counselling was necessary (31 cases), the autopsy permitted to provide the diagnosis in 4 cases and to reassure the family in 17. In 23 cases the post-mortem examination had to be completed by perimortem studies to be contributive. As no antemortem data allowed to predict the value of the autopsy, a postmortem study should by systematically requested in cases of death during the neonatal period.