The use of CPAP has gained popularity enormously now a days in the respiratory management of a newborn. CPAP works on lung mechanics to improve oxygenation by optimizing the FRC by recruiting the collapsed or atelectatic alveoli thereby increasing the alveolar surface area for gas exchange and thus decreasing the V/Q mismatch and reducing the intrapulmonary shunt. It decreases airway resistance and improves lung compliance thereby reduces the work of breathing. The other beneficial effects are stabilizes the chest wall and regularizes the respiration. It also has significant undesirable effects if not monitored appropriately. On cardiovascular system these include mediastinal compression leading to decreased cardiac return. On renal system its ill effects include decrease in GFR and thus urine output. Its adverse affects also include abdominal distention, feed intolerance leading to the so called “CPAP belly”. It increases the intracranial pressure and a high ICP can leads to IVH, hence CPAP should be used judiciously.