Breech presentation is prevalent among preterm deliveries and contributes to neonatal mortality far beyond its prevalence. The management of a preterm breech delivery is controversial. We present our retrospective experience with 185 consecutive preterm breech deliveries, part delivered by cesarean section and part delivered vaginally as assisted breech delivery or total breech extraction), and compare the perinatal outcome between these two groups in terms of perinatal mortality (PPD) and perinatal morbidity (neonatal asphyxia). No statistically significant difference was found for either variable in the two examined groups. We therefore conclude that the method of delivery of low birth weight (1000-2500) breeches has no effect on perinatal outcome.