Resuscitation of the newly born baby is among the most important and commonly performed interventions worldwide. Different approaches have been used for thousands of years depending upon both fashion and the scientific understanding at the time. Artificial respiration and an “ABC” approach has been the mainstay of delivery room resuscitation for about the last 50 years. Over the last 15 years an international collaboration has evaluated the available evidence and published conclusions upon which to base guidelines . Whilst a major step forward, this process has also revealed the lack of evidence for some well established practices. This review will cover some of the historical background as well as the most modern interpretation of the evidence guiding resuscitation at birth in a number of key areas. However, it will also highlight other areas for which further evidence is needed to guide practice. More newborn resuscitation-based research has taken place in the last 10 years, however, it is still true that “There can be few areas of medicine where the potential benefit is so great but which have been subjected to so little evaluation”.