The aim of this study was to examine whether VLBW children had difficulties in peer interactions at 4 years of age. There were 5 VLBW children and 5 age matched controls with normal birth weight, all of whom attended preschool settings in a large town in New Zealand. The type and frequency of peer interactions was assessed using observation and parents and teachers completed questionnaires. VLBW children were observed as interacting less with peers and as having less positive interactions but not more negative interactions. Teachers rated the VLBW children as having more peer problems and parents rated them as engaging in less play interaction. There was also a tendency for the VLBW children to be engaged in more solitary types of play. Trends indicated parents as rating their VLBW children as having more peer difficulties and teachers rating the VLBW children as engaging in less peer disruptive play. These findings indicate that VLBW children manifest decreased peer interactions and deficits in social competence at 4 years of age.