Objective: To report a live birth with IVF-ET and intracytoplasmic sperm injection (ICSI) using sperm retrieved from a moribund man being maintained on life support systems. Design: Case report. Setting: Nonprofit private teaching hospitals. Patient(s): A 27-year-old man who was decorticate after an accident. Intervention(s): Epididymal sperm retrieval and sperm cryopreservation, pastoral psychologic counseling, and subsequent IVF-ET with ICSI. Main Outcome Measure(s): Pregnancy and delivery. Result(s): Birth of a healthy child after IVF-ET with ICSI and single blastocyst transfer. Conclusion(s): First report in peer-reviewed medical literature of a live birth after sperm retrieval from a moribund man. (Fertil Steril(R) 2001 76:841-3. (C) 2001 by American Society for Reproductive Medicine.).