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Objective: Investigate the influence of perinatal factors on short- and long-term outcomes for infants born at 23 weeks of gestation., Study Design: This is a retrospective study over a 25-year period (1987-2011) of 87 successfully resuscitated infants at 23 weeks of gestation. We investigated the effects of poor prenatal care, race, gender, chorioamnionitis, antenatal corticosteroids, delivery route/location, low 5-minute Apgar score, birth weight, and multiple births on short- and long-term outcomes., Results: The mortality rate was 43% (37/87). A total of 88% (44/50) of the survivors were followed at 2 years corrected age with 66% (29/44) diagnosed with a moderate-to-severe neurological impairment. Outborn and multiple birth infants had significantly higher mortality (p-value 0.042 and 0.006, respectively). Lack of exposure to antenatal steroids and lower birth weight significantly increased the disability score (p-value 0.042 and 0.003, respectively)., Conclusion: Multiple perinatal factors significantly influence outcomes at the threshold of viability., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)