Two cases of cecal perforation in neonates due to Hirscbsprung's disease are presented. The clinical features in the two cases were increasing abdominal distension due to dilated bowel and pneumoperitoneum. The diagnosis was missed in the first case and, as a result, the infant was treated by simple closure of the perforation. A correct diagnosis was made in the second case and treatment was by closure of perforations and a transverse colostomy. The diagnosis may be suspected pre-operatively and should be suspected at surgery if a colonic perforation is discovered without any apparent cause. Biopsy of the rectum at the time of the laparotomy is suggested in order to avoid a second anesthetic prior to definitive operative treatment.

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