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Critical Care Medicine www.ccmjournal.org 1395 Manual face-mask ventilation has always been considered a methodology necessary for treating the respiratory failure because it allows to ensure gas exchange in patients who are unable to sustain it spontaneously. It is unfortunate, however, that scant attention has been paid to evaluating the safety and validity of manual ventilation as a life-saving maneuver in different clinical conditions and thus do not dedicate the necessary training to its appropriate acquisition before starting to apply it. It is often the case that for this, maneuver use and application skills are acquired informally in the workplace “by copying” experienced colleagues who themselves acquired it from predecessors who probably may not have received adequate training. The appropriateness of manual ventilation should be evaluated by its capacity to resolve respiratory insufficiency irrespective of etiology, by its ability to prevent the side effects (such as pulmonary emphysema and pneumothorax) and by protecting from the risk of aspiration that can occur when applied without assessing the presence of foreign material in the upper airways. In time, manual ventilation has come to play a major role in carrying out specific ventilation maneuvers in neonatal, pediatric, and adult settings, which require specific devices to be performed appropriately. Two maneuvers, lung opening at birth and recruitment, deserve special mention because they are necessary in the treatment of respiratory failure: