High incidence of postnatal hypothermia has been report-ed in European and Italian preterm infants and it is associated to an increased risk of mortality and morbidity. All efforts should be considered and realized to prevent heat losses at birth in this high-risk population. Effective interventions to avoid these complications include the increase of delivery room temperature and the use of infant warmers, exothermic mattress, woollen caps, plastic wraps, humidified and heated gases. In addition, an adequate organization of the equipment and of the team seems to play a determinant role. Skin-to-skin contact needs to be considered, especially in low resource settings.