We have described early experience with the neonatal arousal scale. The infant's best response to bell and light are assessed and scored in addition to the observation of his spontaneous motor activity or response to tactile stimulation. This approach offers the prospect that rapid, reliable, and repetitive neurologic assessment may be carried out by all levels of personnel caring for small and critically ill neonates. The results of our experience in 100 consecutive patients who survived longer than 24 have been reported.