Traditional management of neonatal respiratory failure has been accomplished with mechanical ventilation delivered by time-cycled, pressure-limited techniques. Although easy to use, this modality results in the delivery of tidal volumes that vary according to pulmonary compliance. In contrast, volume-targeted ventilation delivers a selected tidal volume at variable peak inspiratory pressure, resulting in consistent tidal volume delivery, even in the face of changing compliance. This article reviews salient features of volume-targeted ventilation and a review of the evidence base.