This chapter is a review of the current recommendations of antenatal corticosteroids usage in an impending preterm delivery and the evidence behind them. In an expectant preterm delivery, an intramuscular course of betamethasone or dexamethasone given antenatally, accelerates fetal lung development and helps in the maturation of organ systems. The use of this single strategy has led to significant decrease in preterm morbidity and mortality. The efficacy of the established antenatal steroid protocol in special subsets, including the very early preterm, the late preterm, and multiple gestations is still questionable.