Continuous positive airway pressure (CPAP) and noninvasive ventilation (NIV) hold much promise as means to protect the lungs of newborn infants who have respiratory distress from many causes. A wide variety of options are available to the clinician, including CPAP, bilevel CPAP, and both synchronized and unsynchronized noninvasive mechanical breaths. Limited data are available regarding the best ways to use CPAP and NIV in today's NICU environment. This article reviews current information on these modalities, including available options, possible risks, and unanswered questions.