Non invasive ventilation (NIV) has been shown to be an effective therapy in selected patients with acute respiratory failure. Due to its benefit and relative ease of use, NIV is frequently used. In addition, the shortage and high cost of intensive care beds have prompted the use of NIV outside the intensive care unit. Choosing the right time and type of patient with acute respiratory failure to improve the chances of success with NIV requires an appropriate environment and monitoring. This review presents and discusses the currently available data regarding NIV success outside the intensive care unit, the optimal ventilatory strategy, possible solutions to the mechanical problems and the minimum monitoring required.