Selection of new ventilator systems for the neonatal intensive care unit (NICU), once a simple process due to the limited number of products available, is now a timeconsuming, complex, and multidisciplinary undertaking. Making the best selection involves input from all clinical partners as well as hospital administration. Because ventilator systems now often may be used across the age spectrum, it is necessary to consider whether these devices will be used outside of the NICU. The selection process involves first choosing a multidisciplinary committee, followed by determination of performance and data handling standards. Costs and implementation strategies play a critical role in this process. A request for proposals is prepared and vendors selected for device presentation. Bench testing, either inhouse or by review of others' data, is required, and a clinical evaluation may be part of the process. Finally, the selection is made and the real work begins.