Abstract: Many factors determine the performance and success of delivery room management of newborn babies. Improving the quality of care in this challenging surrounding has an important impact on patient safety and on perinatal morbidity and mortality. Video recording (VR) offers the advantage to record and store work as done rather than work as recalled. It provides information about adherence to algorithms and guidelines, and technical, cognitive and behavioural skills. VR is feasible for education and training, improves team performance and results of research led to changes of international guidelines. However, studies thus far have not provided data regarding whether delivery room video recording affects long-term team performance or clinical outcomes. Privacy is a concern because data can be stored and individuals can be identified. We describe the current state of clinical practice in high- and low-resource settings, discuss ethical and medical–legal issues and give recommendations for implementation with the aim of improving the quality of care and outcome of vulnerable babies. Impact: VR improves performance by health caregivers providing neonatal resuscitation, teaching and research related to delivery room management, both in high as well low resource settings.VR enables information about adherence to guidelines, technical, behavioural and communication skills within the resuscitation team.VR has ethical and medical–legal implications for healthcare, especially recommendations for implementation of VR in routine clinical care in the delivery room.VR will increase the awareness that short- and long-term outcomes of babies depend on the quality of care in the delivery room.