Pediatric cardiopulmonary arrest (PCA) is a rare event; it occurs out-of-hospital in about 8.04 per 100,000 person-years compared to 126.52 per 100,000 person-years in adults [1]. As expected, the mortality is high; one study found one month survival of pediatric out-of-hospital cardiac arrest (OHCA) to be 10.5%, while another study found survival to discharge of pediatric in-hospital cardiac arrest (IHCA) to be 31.3% [2,3]. Achieving higher rates of survival is dependent on many factors in the chain of survival, but the performance of good quality cardiopulmonary resuscitation (CPR) has been shown to be directly associated with survival. In this article, we will define quality CPR in the pediatric patient, review some studies linking certain aspects of CPR with survival in PCA, and review some adjuncts to improve CPR performance.