A 15-year retrospective review of neonates ventilated in the main intensive care unit at the University Hospital of the West Indies was conducted. During the study period, 153 neonates were ventilated, of whom 80 (52%) survived. The most common reason for admission was respiratory distress syndrome, which accounted for 67% (102/153) of admissions, 53 (52%) of these infants survived. Improving outcome will require strategies directed at improving neonatal intensive care.