Although a wide array of respiratory care modalities has been employed to manage neonatal respiratory distress syndrome (RDS), the recent focus has emphasized strategies that correct lung pathophysiology while protecting the lung from further insult. Continuous positive airway pressure (CPAP) has remained a viable option for NICU infants since its introduction in 1971. Current methods of monitoring allow clinicians to troubleshoot and better understand the physiologic and clinical impact of administering CPAP to neonates with RDS. This article highlights the renewed interest in CPAP therapy and current methods of monitoring.