Feeling the pulses of the newborn remains an essential part of their examination. It provides a simple and rapid qualitative guide as to the infant’s cardiac output particularly important if the newborn is sick. It also allows us to consider the possibility of significant congenital heart disease especially affecting the left sided structures, or alternatively a failing myocardium from, for example, a myocarditis, or severe sepsis. The common finding in such ill infants is generalised ‘thready’, poor or absent pulses. Such a finding warrants urgent treatment and investigation including cross-sectional echocardiography which is often only available at a tertiary centre. Repeated assessment of the pulses of the neonate may identify sudden deterioration and the need for timely intervention.