Central venous catheter placement has become commonplace in the care of the premature infant because of the need for long-term venous access. Although generally considered safe, there have been numerous reports of complications from the use of these catheters. We report the case of an infant in whom right hemidiaphragmatic paralysis developed after extravasation of fluid from a central venous catheter. The case emphasizes the need for continued vigilance of central venous catheter location and function.