Neonatal care in developing nations is advancing rapidly. There is an increasing tendency to include nitric oxide in the therapeutic armamentarium. But the opinion regarding its use remains divided among neonatologists even in the western world. Nitric oxide has an established role in the management of persistent pulmonary hypertension in term neonates. However, the use of nitric oxide in preterm neonates has been controversial and the Cochrane review updated in 2001 did not give conclusive answers. There have been adequately powered multi-centre trials recently on the issue, planned to resolve the controversy. The present communication highlights the salient features and conclusions drawn from these trials.