Children with chronic respiratory failure may benefit from long-term mechanical ventilation via tracheostomy at home. Although caring for a chronically-ventilated child at home poses implicit risk, such care can be provided safely in this setting. In some cases, chronic respiratory failure improves over time and permits weaning ventilation and tracheostomy decannulation. Approaches to caring for technology-dependent children vary significantly among centers. Experts in pediatric pulmonology, aerodigestive evaluation, critical care, and sleep medicine will discuss important aspects of caring for this fragile patient population. An interactive roundtable discussion will follow to encourage audience participation.