The role of natural killer (NK) cells in hematopoietic stem cell transplantation and in the control of neonatal infections is not yet clear. Donor-versus-recipient NK cell alloreactivity was found to improve outcome in some settings of hematopoietic stem cell transplantation. We hypothesized that the role of NK cells in cord blood (CB) transplantation and neonatal infections may depend on CB NK cell maturation stage. We therefore analyzed the expression of NK cell differentiation/phenotypic markers in human CB, as well as functional properties of purified CB NK cells. CD8 and CD57 expression was lower in CB than in adult NK cells. However, the expression of other differentiation markers was similar, as was cell surface density of CD56, the percentage of late NK cell precursors, interferon-␥ production, and the proliferative response of purified NK cells to IL-2. Spontaneous cytotoxic activity of purified CB NK cells against NK-sensitive targets was low but reached adult levels after treatment with IL-15. Expression of perforin and granzyme B was higher in CB NK cells (90 versus 58% and 86 versus 69%, respectively Natural killer (NK) cells are innate immune lymphocytes defined by their cell surface expression of the CD56 antigen without expression of the CD3 antigen. They display a broad anti-infectious and antitumor cytolytic activity. They can also secrete various cytokines, such as interferon (IFN)-␥ and other cytokines that regulate the immune response and hematopoiesis (1). Although NK cells play an important role early in the infectious cycle, at a time when specific immunity has not yet fully developed, their role in the defense of the neonate against infection has not been studied (2). It was demonstrated recently that NK cells play an important role in the outcome of clinical HLA-haploidentical hematopoietic stem cell transplantation (1,3). A positive effect of NK cell alloreactivity has also been reported in a series of unrelated hematopoietic stem cell transplantations (4). We, as several other groups, use cord blood (CB) as a source of stem cells in partially HLA-mismatched transplantation with outcomes similar to those observed in HLA-identical bone marrow transplantation (5-9). CB contains a higher percentage of NK cells than adult blood-, bone marrow-, or cytokine-mobilized peripheral blood stem cell grafts (10). It thus is tempting to speculate that neonatal/CB NK cells may play a role in CB transplantation as well as in the control of neonatal infections.Several markers of NK cell immaturity have been described. Among these is the level of cell-surface expression of CD56.