Background: Premature birth is associated with an increased risk for the development of cognitive, learning and psychological problems in childhood. It is uncertain which problems remain, which decrease and which problems may newly arise in the transition from childhood into adulthood. Objective: The following question should be answered: how do those infants born very preterm (VP <32 weeks gestation) or of very low birth weight (VLBW <1500 g) master the transition into adulthood compared to full term infants? Material and methods: The Bavarian longitudinal study is a geographically defined study of VP and VLBW infants born in 1985 and 1986. Out of 411 VP and VLBW survivors that still lived in Germany 260 (63 %) were reassessed at 26 years of age together with 229 out of 308 full term born infants (74 %) from the same period. Most participants had taken part in all seven follow-up visits throughout childhood. The major findings are reviewed in the context of results from other cohort and register studies around the world. Results: Most of the difficulties identified in childhood (e.g. multiple cognitive problems, anxiety, withdrawn personality and social problems) remained into adulthood. These have adverse effects on economic independence and the quality of life. Conclusion: It is crucial to carry out long-term investigations of older and new cohorts up into adulthood to answer the question whether improved obstetric and neonatal care has not only led to improved survival but also to improved quality of survival.