Summary Backround Meconium aspiration syndrome is a disease of the newborn mature or post mature. The acute pulmonary consequences can be extremely severe. In the few studies of the long-term pulmonary sequelae, it seems that certain children surviving meconium aspiration syndrome keep an obstructive syndrome. The aim of our study was to assess long term respiratory residual damage from meconium aspiration syndrome. Methods During a seven-year period going from 1994 to 2000, we reviewed the files of children hospitalized in neonatology departement of Sfax for meconium aspiration syndrome. The children who were convoked (group M: n = 27), underwent spirometry, followed by an exercise stress. An age matched control group (group C: n = 23) of healthy children was investigated in the same way. Results The group M comprised 15 boys and 12 girls aged four to 11, an average of 7 ± 1.9 years. With the study of the respiratory function, we did not find an obstructive syndrome. Spirometry revealed a total pulmonary capacity in an average of 133 ± 55.65% of theoretical (group M) versus 105.5 ± 27.96% of theoretical (group C) ( P < 0,01), testifying to alveolar hyperinflation. Spirometry fulfilled 5, 10 and 15 min after exercise showed a FEV1 reduction of respectively 8.5 versus 2 ( P < 0.05); 9.5 versus 3 ( P < 0.01) and 10.5 versus 4 ( P < 0.05). Conclusion Children surviving meconium aspiration syndrome tend to develop alveolar hyperinflation and airway hyperreactivity to exercise.