Current resuscitation guidelines contain little specific guidance about the resuscitation of preterm infants. Although the basic principles of resuscitation apply in all age groups, most preterm infants are more in need of stabilization than resuscitation. Evidence is accumulating to suggest that actions taken in the first few minutes of a preterm infant's life may impact on their entire neonatal course and their final outcome. The options facing the clinician are complex, and dictate that, wherever possible, the initial stabilization of a preterm infant should be directly supervised by an experienced specialist. This review summarizes the present data that relate to the methods used to resuscitate preterm infants at high risk of mortality and morbidity.