The landscape of neonatal follow up is starting to shift. While there is continued emphasis on the traditional outcomes studied, including cerebral palsy, vision/hearing impairment, and cognitive impairment, there is a shift in focus to those outcomes which are much more prevalent and collectively can contribute to significant morbidity. The purpose of this review is to explore the outcomes of the preterm survivor, in the context of the principles of neurodevelopment. Approaching these outcomes from a developmental perspective provides insight into the challenges in early identification and management of these highly prevalent outcomes. In addition, we will explore the underlying brain injury associated with the preterm infant, particularly as it relates to the high prevalence low severity outcomes. We will also review the impact of this pattern in terms of clinical presentation and academic performance. Finally, we will look at the limitations within the medical system and community that potentially exacerbate the difficulties of the preterm survivor.