This paper reviews current literature on feeding and swallowing of the premature and high-risk infant. If addresses issues of maturation and organization that affect feeding abilities. Evaluation issues including instrumental evaluations (e.g., cervical auscultation, modified barium swallow studies) are discussed. Finally, common problems seen in this population are described along with the wide range of management strategies to consider. Whenever intervening with this fragile population a team approach must be used; the individual needs and behavioral cues of the infant must be read, respected, and responded to, while ensuring that families play an integral part of the process.