Abstract: Changes in heat and precipitation as a result of climate change are expected to have adverse effects on health, particularly among the most vulnerable populations. These changes can affect health both directly, through extreme events and changes in the disease environment, as well as indirectly through its impact on the economic livelihood of the population. In this paper we utilize an extensive dataset of over 400,000 births combined with detailed historical geo-spatial weather data on temperature and rainfall to investigate the impact of extreme weather events on infant survival in Africa. Our results suggest that both extreme heat and extreme rainfall affect the likelihood of infant survival. In particular, we find that excessive heat around the month of birth is predictive of an increased likelihood of death, particularly for neonates but also for older infants. Rainfall during the third trimester of pregnancy increases the likelihood of death for neonates. We also find evidence that excess rainfall can be protective under certain scenarios, most likely as a result of positive income shocks. Utilizing our empirical estimates, we explore four different climate change scenarios that suggest an additional 400 to 900 thousand infant deaths in Africa over the period 2010-2030, due to the impact of increased heat and precipitation change, in the absence of effective adaptation or mitigation efforts.