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To study the impact of videolaryngoscopy (VL) on intubation success among pediatric trainees compared with direct laryngoscopy (DL).One hundred pediatric residents were enrolled in a randomized, crossover, simulation study comparing VL to DL. Following a didactic session on neonatal intubation, residents intubated a standard neonatal mannequin. Three Neonatal Resuscitation Program (NRP) scenarios were then conducted, followed by a mannequin intubation with the alternate device. Number of attempts and time to intubation were recorded for all intubations.Proportion of successful intubations on first attempt was greater with VL compared with DL (88% versus 63%; P = 0.008). The DL group increased success after crossover with VL (63% versus 89%; P = 0.008). Exposure to VL also reduced intubation time after device crossover (median intubation time: 31 versus 17 s; P = 0.048).VL increased the success of endotracheal intubation by pediatric residents in simulation, with skills transferrable to DL.