Continuous positive airway pressure (CPAP) was used to treat severe respiratory distress in four infants with bronchomalacia. Fiberoptic bronchoscopy diagnosed the area of bronchomalacia, documented the effects of CPAP on the airway, and helped determine an effective level of CPAP. CPAP immediately decreased respiratory distress, and was correlated with improved airway patency in the formerly collapsed airways. All four infants, including three who had required prolonged mechanical ventilation, maintained spontaneous ventilation on CPAP.