Objective: To contrast the rates of neurosensory disabilities at age 8 years in extremely low birth weight (ELBW; birth weight 500 to 999 g) children born in the state of Victoria, Australia in 4 four distinct eras from the late 1970s to the late 1990s. Study design: Study subjects were assessed at age 8 years. Results were compared among 4 ELBW cohorts (87 of 89 children born in 1979-1980, 206 of 212 born in 1985-1987, 224 of 241 born in 1991-1992, and 160 of 170 born in 1997), and between each of these ELBW cohorts and normal birth weight (NBW; birth weight > 2499 g) controls. Results: The survival rate for ELBW children rose from 25% for the 1979-1980 cohort to 73% for the 1997 cohort. No statistically significant differences in the disability rates were seen in the 4 eras; however, in the 1997 cohort, disability rates were significantly higher in the ELBW children compared with NBW controls: mild disability, 36.7% vs 9.8%; moderate disability, 10.1% vs 2.3%; and severe disability, 8.2% vs 0.6%. Conclusions: The survival rate of ELBW children continues to rise over time. Despite this, however, the rates of disability in these vulnerable children at school age have remained stable and high relative to controls.