To investigate whether infants <29 weeks gestation who receive positive pressure ventilation (PPV) immediately after birth with a T-piece have higher oxygen saturation (SpO) measurements at 5 minutes than infants ventilated with a self inflating bag (SIB). STUDY DESIGN: Randomized, controlled trial of T-piece or SIB ventilation in which SpO was recorded immediately after birth from the right hand/wrist with a Masimo Radical pulse oximeter, set at 2-second averaging and maximum sensitivity. All resuscitations started with air. RESULTS: Forty-one infants received PPV with a T-piece and 39 infants received PPV with a SIB. At 5 minutes after birth, there was no significant difference between the median (interquartile range) SpO in the T-piece and SIB groups (61 [13 to 72 versus 55 [42 to 67 ; P = .27). More infants in the T-piece group received oxygen during delivery room resuscitation (41 [100 versus 35 [90 , P = .04). There was no difference in the groups in the use of continuous positive airway pressure, endotracheal intubation, or administration of surfactant in the delivery room. CONCLUSION: There was no significant difference in SpO at 5 minutes after birth in infants <29 weeks gestation given PPV with a T-piece or a SIB as used in this study.