Premature newborn rabbits, delivered on day 27 of gestation, were subjected to positive-pressure ventilation, with or without treatment with natural surfactant. The surfactant, obtained by centrifugation of lung wash from adult rabbits, was deposited in the tracheal cannula before the onset of ventilation. Parameters of lung mechanisms, recorded during spontaneous ventilation after 1 h, were significantly improved in animals receiving surfactant. In comparison with littermate controls, surfactant-treated animals also had less prominent bronchiolar epithelial lesions. We conclude that treatment with supplementary surfactant facilitates functional adaptation of the premature lung and prevents the development of epithelial lung lesions during artificial ventilation.