Respiratory syncytial virus (RSV) is a potent pathogen causing annual epidemics of serious illness in young infants. Controversy over interventions has evolved given conflicting research results concerning the disease process and the variety of treatment options. Investigations over the last two decades have provided more insight into the complexity of this sometimes deadly infection and better understanding of the reasons why treatment is so elusive. Currently, RSV infection cannot be prevented, and there is no definitive cure. The article discusses the pathophysiology of RSV and provides a description of the available treatment approaches currently in use and those under development.