The chapter describes different clinical case scenarios presenting in day to day in practice and their step by step respiratory management with CPAP. These cases demonstrate the principle of early recruitment of FRC in preterm babies and successful evolution to a steady state due to optimal use of early CPAP. In the babies who exhibit worsening respiratory scores, especially if combined with decreasing pH and abnormalities of perfusion, elective intubation is done. A check list for CPAP and extubation failure has been described.