The outcome in 148 inborn meconium-stained neonates was studied prospectively over a 5-month period. Fifty-three infants (38.5%) developed meconium aspiration syndrome (MAS). There was a significantly higher rate of MAS (p < 0.001), mechanical ventilation (p < 0.016) and hospital stay (p < 0.016) in neonates with meconium in the trachea than in neonates with no meconium in the oropharynx. The incidence of MAS was significantly higher and the duration of hospital stay longer in outborn than in inborn infants (p < 0.022).