PURPOSE: To examine whether a relationship exists between a neonate's weight and the neonate's receipt of comfort medication between four hours prior to elective ventilator withdrawal and death. It was hypothesized that the greater the neonate's weight, the more likely the neonate was to receive comfort medication at end of life. DESIGN: A retrospective chart review. SAMPLE: One hundred seventy-one neonates in a midwestern Level III NICU who died after withdrawal of ventilatory support. RESULTS: Of the 171 neonates in the sample, 27.5 percent (n = 47) did not receive comfort medication within the designated time frame; neonates who weighed < 800 g were significantly less likely to receive comfort medication than were their heavier cohorts. CONCLUSION: In this sample, smaller neonates were given comfort medication less often while they were dying than were their larger counterparts.