Emergent care of newly born baby in distress and an infant requiring cardiopulmonary resuscitation are both high-risk, low-frequency events for EMS providers, yet they require fundamentally different approaches. Confusion between Neonatal Resuscitation Program (NRP) and Pediatric Advanced Life Support (PALS) principles can lead to delays, inappropriate interventions, and increased risk of error in the prehospital setting. This session provides a practical, case-based comparison of NRP and PALS, focusing on when and how to apply each approach in real-world EMS scenarios. Participants will review key physiologic differences, initial priorities, and critical interventions that distinguish newborn resuscitation from pediatric cardiac arrest resuscitation. Emphasis will be placed on simplifying decision-making, avoiding common pitfalls, and improving confidence in managing these high-stakes patients. This talk equips ALS providers with clear frameworks they can immediately apply in the field. In addition, in-depth consideration of each approach will be reviewed using the new 2025 AHA updates.