Infantile hypotonia presents significant challenges in the pre-hospital setting. As a paramedic or EMT you will likely respond to calls involving both acutely and chronically ill children. The skill of accurately and rapidly assessing a pediatric patient’s tone is essential in the first moments of an encounter. Developing an approach to handling severe abnormalities comes with training and experience. In general, preparing for these encounters both in thought and in practice is a must to do your best out there. This article will explore hypotonia and provide background on the topic, as well as a few cases, that may aide pre-hospital professionals in further improving their preparedness in this arena.