Ventilatory failure, often complicated by pulmonary infection, is a common cause of death in neuromuscular disorders. When severe enough, only intubation and mechanical ventilation can avoid a fatal outcome. In acute, reversible neuromuscular problems, mechanical ventilation is simple and safe, even if long lasting. Pulmonary function tests, particularly repeated vital capacity measurements, are very useful to predict respiratory failure and conduct weaning trials from the respirator. In chronic, progressive and debilitating neuromuscular disorders, to intubate or not remains an ethical dilemma. In an hospital admitting such patients, a clear and explicit consensus about the general policy for the treatment of chronic neuromuscular patients should have been previously discussed to avoid erratic therapeutic options.