Objective. To investigate changes in head lag across postmenstrual age and define associations between head lag and (1) perinatal exposures and (2) neurodevelopment. METHOD. Sixty-four infants born ≤30 wk gestation had head lag assessed before and at term-equivalent age. Neurobehavior was assessed at term age. At 2 yr, neurodevelopmental testing was conducted. RESULTS. Head lag decreased with advancing postmenstrual age, but 58% (n = 37) of infants continued to demonstrate head lag at term. Head lag was associated with longer stay in the neonatal intensive care unit (p =.009), inotrope use (p =.04), sepsis (p =.02), longer endotracheal intubation (p =.01), and cerebral injury (p =.006). Head lag was related to alterations in early neurobehavior (p <.03), but no associations with neurodevelopment were found at 2 yr. CONCLUSION. Head lag was related to medical factors and early neurobehavior, but it may not be a good predictor of outcome when used in isolation.