In 10 years (1981 - 1990) 28 out of 54 neonates (51.8%) with definite necrotizing enterocolitis (NEC) underwenl surgery. Operation was performed al 13.5 ± 8.8 (range 3 38) days of lifc, after 1.7 f 1.5 (range 1 --6) days from the onset of symptoms. Aiming to perform laparotomy before the occurrence of perforation, surgery was liberally indicated in stage IIIa, according to Walsh-Kliegman. Explorative laparotorny (+pcritoneal drainage in 2 cases) was performed in 4 patients with massive intestinal necrosis: all died within 3 days of surgery. In one neonate, only pneumatosis was present and resection was not considered mandatory. Intestinal resection and enterostorny was performed in 17 neonates, 5 of them with perforation; three developed an intestinal stenosis. 6nterostomy was closed after 116.2 f 61.8 days (range 26--193); 11 patients (64.7%) are long-terni survivors. Intestinal resection and primary anastomosis was performed in 6 babics, 3 of them with perforation. Postoperatively, 2 dehiscences and 1 stenosis avere recorded, but all children survived. In our opinion, resection followed by primary anastomosis seans to bc the most salisfactory surgical option