OBJECTIVE To analyse the indications, clinical profile, complications and outcome of the babies requiring mechanical ventilation. METHODS Retrospective study. METHODS NICU of a teaching hospital. METHODS One hundred and twenty one neonates requiring assisted ventilation during three years. RESULTS Of 121 babies 59(48.76%) survived. Hyaline membrane disease (HMD) was the commonest indication for ventilation followed by birth asphyxia, apnea of prematurity, meconium aspiration syndrome (MAS) and septicemia. Infants with HMD whose birth weight was more than 1.5 kg and those who required ventilation after 24 hours of birth had better outcome. Survival rates increased with increasing birth weight and gestational age. Prolonged ventilatory support was needed for HMD (mean 117.3 hr) and MAS (mean 82.6 hr). Pneumonia was the commonest complication, followed by sepsis, air leak syndromes and intracranial and pulmonary hemorrhage. CONCLUSIONS Ventilatory facilities must be focussed for neonates weighing > 1000 g. Assisted ventilation may not be cost-effective in patients weighing < or = 1000 g and those with complex heart diseases and other congenital anomalies.