The outcome of 117 consecutive cases of open spina bifida treated unselectively from birth between 1963 and 1970 and reviewed 16-20 years later is reported from the Department of Urology, Addenbrooke’s Hospital, Cambridge, England. Forty-one percent died before their 16th birthday and most of the survivors were badly handicapped: 50% were wheelchair dependent, 30% were mentally retarded and 75% relied on an appliance or padding for incontinence. The majority had had a shunt inserted within hours of birth. 75% were incapable of employment and 50% were unable to live without help or supervision. The sensory level at birth provided a yardstick for predicting the range of handicap into adult life and was useful in counseling parents concerning the child’s long-term prognosis. With a sensory level above T11 the disability would be severe, with no prospect of walking or of continence and with a 10% chance of independent living. A sensory level between T11 and L3 (from the umbilicus to the knees) should indicate a moderate disability in 60% and a capability of living independently in 45%. A sensory level below L3 should predict a survival rate of 75% and a normal intelligence in 80%; 90% would be ambulant as adults and 45% would be continent; and 85% would be totally independent with moderate or minimal disability. [1]