Clinical reports of endotracheal (ET) intubation of infants by paramedics suggest suboptimal success rates. Methods to improve the performance of paramedics in ET intubation should be explored. The small, anesthetized cat may be utilized to evaluate infant ET intubation performance. By determining success rates and complications of ET intubation in the cat model, analysis of the current skills and the impact of a short didactic session is described. Unprepared paramedics (n = 36) were randomized to an educational (experimental) or control group. Supervisory personnel evaluated ET tube placement and complications. There was no significant difference in the percent of successfully intubated cats, 67% and 57%, respectively, between experimental and control groups. Fifteen percent of successful ET intubations exceeded 30 seconds of intubation time. The experimental group chose appropriate equipment more frequently. Serious complications occurred in 50% of attempted intubations. There was a poor correlation between performance and measures of paramedic experience. Development of educational methods is required to improve infant ET intubation success and reduce complications.