Non-invasive ventilation (NIV) has resulted in a significant improvement in outcomes of children with neuromuscular disease. The most common indication for starting NIV in this group of children is for the treatment of sleep disordered breathing/ nocturnal hypoventilation. Other indications include the prevention of chest wall deformity and to facilitate post-operative outcome of spinal surgery. In this presentation, on overview of the literature will be discussed and illustrative clinical cases will be presented. It is an exciting time with the advent of several new disease modifying therapies and the impact of these will also be explored.