Despite a even more frequent use to non-invasive respiratory support, mechanical ventilation is stilloften necessary for supporting premature infants with lung disease. Protracted mechanical ventilation is associatedwith increased morbidity and mortality and thus the earliest weaning from invasive respiratory supportis desirable. Weaning protocols may be helpful in achieving more rapid reduction in support. However,no consensus has been reached on criteria to identify when patients are ready to wean or how to achieve it. Inthis article, available evidence is reviewed and reasonable evidence-based recommendations for weaning andextubation are provided.