There is a growing need for advanced practice providers in the NICU. Physician assistants (PAs) with postgraduate training in neonatology can help meet these demands. The premise of training PAs to work in the NICU is being adopted by multiple centers nationwide. Unfortunately, there are no standardized curricula for neonatal PA training that can be utilized to initiate residencies. Since our program is the longest running neonatal PA residency in the nation, we are in a unique position to share the accumulated experiences of our curriculum development. In this article, we describe our neonatal PA residency as it exists today with selected lessons learned. In addition, we present mixed qualitative and quantitative assessments of graduates. We believe that neonatal PA residency graduates become ideal candidates to fill the growing national need. We propose that our model program can be a stepping stone to enhance the role of PAs in neonatal care.