The fetus to newborn transition is a complex physiologic process that requires close monitoring. Approximately 10% of all newborns require some support in facilitating a successful transition after delivery. Clinicians should be aware of the physiologic processes and pay close regard to the newborn's cardiopulmonary transition at birth to provide appropriate treatment and therapies as required. Trained Personnel in the Neonatal Resuscitation program should be available at the delivery for all newborns to ensure that immediate and appropriate care is provided to achieve the best possible outcomes for those babies not smoothly transitioning to extrauterine life.