An extensive review of the literature suggests that priapism or prolonged penile erection is extremely rare in the newborn. We present a term newborn whose clinical course of prolonged penile erection was a result of polycythemia. In the past, only 3 cases appear to have been associated with polycythemia. However, two of these cases had several other complicating factors. The remaining episodes have been described as idiopathic (7), or attributed to infection (1) or central nervous system insult (1). The recognition of this phenomenon and its historical record of clinical course is important in the newborn so inappropriate approaches to treatment may be avoided. Because of spontaneous detumescence in many instances, observation or nonsurgical management is advocated for the newborn with prolonged penile erection.