OBJECTIVE: To study the incidence of early complications and treatment outcomes in premature infants conceived via test tube. METHODS: A retrospective analysis and comparison was conducted on the clinical data of 122 test-tube premature infants and 183 naturally conceived premature infants (control group), including maternal complications, birth conditions and early complications. RESULTS: There was no statistically significant difference in maternal complications between the two groups (P>0.05). The incidence of respiratory distress syndrome (25.4% vs 12.0%; P<0.05) and malformations (3.3% vs 0%; P<0.05) in the test-tube group was statistically higher than in the control group. The mortality rate in the test-tube group was statistically higher than in the control group (9.0% vs 2.2%; P<0.05). CONCLUSIONS: Test-tube premature infants are more likely to suffer from respiratory distress syndrome and have higher incidences of congenital malformations and mortality. Asisted reproductive technique should therefore be chosen cautiously, and enhanced assessment and monitoring is needed during pregnancy.