This long-term, prospective study evaluated repeatedly school readiness and adjustment at kindergarten and first grade of children with extreme intrauterine growth restriction (IUGR; n = 20) in relation to controls (n = 19). Methods included individual testing of cognitive competence, self-perception, motivation, loneliness and academic achievements; parental anxiety and family-functioning; and teacher ratings of cognitive, emotional, and social adjustment. Children with IUGR had lower cognitive and achievement scores and frequent impulsivity. However, they experienced no socioemotional difficulties. Children in this group, particularly boys, who had mild cognitive difficulties, rule breaking tendencies, and social adjustment issues experienced academic adjustment difficulties during the first school year. Findings underscore a susceptibility of children born with extreme IUGR to develop learning difficulties, and highlight their initial socioemotional resilience.