Review on accidental extubation from the literature. Effects of accidental extubation on the baby and wider impact parents/staff and outcome. Challenges of capturing data on accidental extubation. Results of a quality improvement project on accidental extubation. Extubation event is common in the neonatal unit. Accidental (unplanned) extubation should be uncommon. However, accidental extubation events are often not measured/ under reported and it’s perceived as normal’’. This quality improvement project aims to determine the frequency and characteristics of accidental extubations in preterm infants in a large neonatal unit and strategies to manage the issues around its occurrence.