This study investigates the developmental patterns of cognitive performance over the first 3 years in a large sample of Black and White low-birth-weight (LBW), premature children (N = 762), selected from the Infant Health and Development Program (IHDP). The IHDP is a randomized clinical trial to test the efficacy of education and family support services in reducing the incidence of developmental delay in LBW preterm infants at 8 clinical sites. Developmental patterns are identified by means of cluster analysis on the basis of the intelligence test scores at 12, 24, and 36 months (corrected for gestational age). Five developmental patterns were identified, including (a) high stable, (b) high decline to average, (c) high decline to below average, (d) average decline to below average, and (e) very low stable. Results reveal that these patterns of cognitive development can be discriminated by 3 dimensions: maternal environment, children's neonatal health status, and treatment. Mother's cognitive ability and the quality of child's home environment were also found to be associated with LBW children's developmental patterns.