Introduction Prompt, skillful resuscitation of distressed neonates in the immediate postpartum period is one of the most important responsibilities of the practicing pediatrician. The potential for death or life-long morbidity is high in these Vulnerable infants, but it can be reduced dramatically by effective intervention. Because many of these situations are unpredictable, all deliveries should be attended by at least one person skilled in neonatal resuscitation, and additional help should be readily available. Although a certain amount of practice is needed to master and maintain the necessary manual dexterity skills, the vast majority of neonatal resuscitations are relatively simple procedures. Most depressed infants respond to ventilation with oxygen; only a few require chest compressions or medication. Vascular access usually is not needed, and most infants can be ventilated adequately by bag and mask. Advance preparation and adherence to a few basic principles are the keys to effective intervention. The role of the pediatrician should go beyond maintaining expertise in neonatal resuscitation and responding to emergencies. Pediatricians should be teachers and role models for obstetricians, nurses, and other health professionals involved in perinatal care. They should be participate in planning for and monitoring the performance of neonatal resuscitation. They also must provide acute care and follow-up for resuscitated infants.