From a review of published literature on developmental responses to high altitude, three major conclusions are derived. First, the small birth weight of high altitude native populations are adaptive responses to reduce the oxygen requirements, while the relative increase in the placental weight is a compromise mechanism to increase the volume and surface area for a better oxygenation. Second, the small stature of the high altitude native is due to slow prenatal and postnatal growth. Third, the enlarged chest size, increased lung volumes and predominance of the right ventricle of the heart are due to accelerated development during childhood and adolescence. However, there is not adequate information to determine whether or not the developmental responses of the high altitude native are population-specific, based on a genetic structure different from that of sea level populations. Hence, the need for further study of developmental factors is emphasized.