Nearly all global under-five mortality (U5M) (99%) occurs in developing countries. The leading causes of U5M worldwide, pneumonia and diarrheal illness, account for 1.396 and 0.801 million annual deaths, respectively. While important advances in prevention are being made, advanced life support (ALS) management in children in the developing world is often incomplete due to limited resources. Existing ALS management guidelines for children in LR settings are largely empirical not evidence-based, written for the hospital setting, not standardized with a systematic approach to patient assessment and categorization of illness, and taught in current pediatric ALS training courses from the perspective of full-resource settings. Extending higher quality emergency and critical care services to children in the developing world is the focus of this session. Simple inexpensive ALS management when integrated into existing programs of primary care can improve child survival across the globe.