At lot is known about acquisition of respiratory syncytial virus (RSV) in pediatric wards inside the hospital. However, only few data are available on the incidence of RSV infections in neonatal intensive care units (NICUs). The aim of the present study was to test the hypothesis that a considerable number of preterm infants acquires RSV already at the NICU, prior to the first discharge home. In order to test this hypotheses, a prospective epidemiologic survey (twice weekly analysis of nasopharyngeal swabs for RSV by seminested RT-PCR for a period of 8 weeks) was performed in all preterm infants submitted to the NICU and Intermediate Care Unit of the Medical University Vienna, the medical and nursing staff as well as the parents/visitors of the included patients. In total 1002 samples were collected. Only 2 samples from 1 patient tested positive for RSV as did 2 samples from medical staff. The patient had acquired serious RSV infection and ultimately died from complications during the infection. In Conclusion nosocomial RSV infections are a rare event at the NICU and Intermediate Care Unit, although these infections have a considerable risk of an adverse outcome in this setting.