Each year, thousands of Thoroughbred foals require intensive neonatal care, with respiratory compromise a leading cause of prolonged hospitalisation. This project evaluated the use of non invasive ventilation (NIV), specifically bi level positive airway pressure (biPAP), as a practical and less invasive alternative to mechanical ventilation for foals with breathing difficulties. The findings demonstrate that NIV can safely improve oxygenation, lung function and breathing mechanics, supporting better short and long term health outcomes for neonatal foals.