Tachypnea and cyanosis in the newborn are frequently encountered problems in the nursery. The incidence of respiratory distress ranges from 2.9% to 7.6%, and 4.3% of newborns may require supplemental oxygen therapy. In this article, the pathophysiology,approach to the diagnosis, and management of clinical conditions are discussed. The physiologic mechanisms involved in the pathogenesis of these problems and the clinical assessment and early stabilization of an infant before transport to a tertiary care center, if necessary, are also discussed.