Many factors contribute to the poor perinatal performance seen with the low-birth weight (LBW) breech infant. The factors responsible may be classified as those over which the obstetrician can and cannot exert control. Elective cesarean section is being utilized increasingly in an attempt to improve outcome; however, several authorities have questioned the validity of such intervention until alternative types of management have been evaluated. One possible alternative is to use an intensive intrapartum management scheme with a demonstrated efficacy in term breech management. The authors report retrospectively on the outcome seen among LBW breech infants delivered vaginally with such a protocol. The distribution of untoward perinatal events between the protocol and nonprotocol groups was unaffected by the application of the principles shown to be effective with mature breech infants.