The use of non-invasive ventilation (NIV) within paediatrics has increased significantly in recent years, probably due to improved understanding of its role and a rising confidence in its ability to provide respiratory support to children. NIV is a valuable treatment option for respiratory failure due to a variety of causes, both acute and chronic. Its ease of use allows its application in both the hospital and community setting. This article gives an overview of NIV use in the paediatric population, highlighting medical and nursing considerations that are important. Appropriate assessment, well-managed initiation with continued follow-up and support is vital for families and children embarking on NIV as a long-term respiratory support.