Respiratory syncytial viral infection is the leading cause of acute lower respiratory tract disease in infants and young children. Presenting symptoms include rhinorrhea, nasal congestion, a low grade fever, and a cough. Hypoxemia and respiratory acidosis are the most common presentation for infants requiring intensive care. Critical care nurses must skillfully assess the infant's clinical status and response to medical treatment, implement and enforce isolation procedures, and remain sensitive to the emotional and psychologic needs of RSV-infected infants and their families. They must be knowledgeable regarding the latest research and recommendations concerning isolation policies and safe administration of ribavirin therapy in order to maximize the care for infants experiencing acute respiratory distress caused by RSV infection.