Chronic lung disease is the most common adverse outcome in survivors of prematurity. These infants experience frequent hospitalisation because of respiratory-related illness in their first year, as well as persistent cough, wheeze and oxygen dependence. Although the severity of respiratory illness decreases and supplemental oxygen is needed less as their lungs mature, childhood is still complicated by persistent wheeze, cough and reduced exercise tolerance in comparison with their peers. Although there is little longitudinal follow-up data beyond adolescence, imaging studies suggest that these infants are highly likely to suffer with respiratory problems akin to chronic obstructive pulmonary disease in later adulthood. The nature of their long-term respiratory problems, the impact of cigarette smoking and the effect on life expectancy are all unanswered questions that need addressing as these infants grow up.