Patient-triggered ventilation is a relatively recent development in neonatal mechanical ventilation. Advances in microprocessor-based technology, transducers, and monitoring have enabled patient-driven ventilator control and synchronization of mechanical ventilation with patient effort. The novelty of the newer ventilatory techniques has generated several controversies that remain to be resolved. Among these are signal detection and transduction, the optimal ventilatory modes, and weaning during patient-triggered ventilation.