An observational study from Australia tried to determine whether the color of an infant’s tongue predicted the need for supplemental oxygen during neonatal resuscitation. The tongue color was visually assessed by midwives and pediatric trainees at one to seven minutes and ten minutes after birth, and simultaneously compared with oxygen saturation on pulse oximetry. Whether the tongue was pink or not was assessed against the reference standard of an oxygen saturation of less than 70%. The sensitivity of a non-pink tongue in determining an oxygen saturation of less than 70% was only 26% but the specificity was 96%. Based on this study, when the tongue is pink the infant is highly likely to have an oxygen saturation above 70% and does not require supplemental oxygen. However, if the tongue is not pink, we cannot reliably decide about the need for oxygen.