Respiratory syncytial vrus (RSV) infection is a signifi cant health burden, especially in premature infants. Despite this, prophylaxis coverage of high-risk infants and infants born prematurely is suboptimal. This monograph will review the pathophysiology and epidemiology of RSV infection, focusing on this uniquely vulnerable population. Management methods and treatment options will be evaluated. The importance of prophylaxis will be presented, along with guidelines put forth by the American Academy of Pediatrics regarding treatment and prophylaxis for high risk, preterm, and late preterm infants. Practical advice for overcoming barriers to achieving adequate prophylaxis and adherence to treatment regimens will be given.