Necrotizing enterocolitis (NEC) is a serious gastrointestinal disease that primarily affects premature or very low birth weight infants. It is the most common and serious intestinal disease among premature babies. The condition inflames intestinal tissue, causing it to die, and a hole (perforation) may form in the babys intestine. Bacteria can leak into the abdomen or bloodstream through the hole. Symptoms of NEC may include poor feeding, bloating, decreased activity, blood in the stool, vomiting of bile, bowel death, multiorgan failure, and even death. The exact cause of NEC is unclear, but several risk factors have been identified, including formula feeding, intestinal dysbiosis, low birth weight, and prematurity. Diagnosis of NEC is more challenging in premature infants due to inexplicit symptoms and radiographic signs. Treatment for NEC includes temporarily stopping all feedings, relieving gas from the bowel, and starting antibiotic therapy. Surgery may be needed if there is a hole in the intestines or peritonitis. When NEC is diagnosed and treated immediately, the prognosis for babies is generally very good, and most babies recover fully without any additional health problems. However, NEC is a serious disease with a death rate approaching 25 percent.