It is pleasure to come out with fourth edition of Basic Pediatric Intensive Care, which continues to find favor with young residents and general pediatricians. In the period since the last edition in 2009, several advances have taken place in knowledge and practice and that is the rationale for this edition. The book continues to maintain simplified format and covers all the basic critical care issues relevant to our children. In this edition, all the topics have been thoroughly revised and updated. New topics have been added and redundant material has been deleted. The new chapters include Raised Intracranial Pressure, Fluid and Electrolyte Therapy and Infection Control in PICU. Major changes have been made in the chapters on Cardiopulmonary Resuscitation to incorporate new CPR guidelines, Management of Septic Shock in accordance with consensus guidelines for resource limited countries, and Acute Renal Failure to incorporate new advances and approach. The chapter on Severe Infections now has updated choice of antibiotics and a whole section on Approach to Tropical Fevers. The chapter on Metabolic Changes and Nutrition has been revised to include recommendations on nutrition management of critically ill children with underlying malnutrition. The chapter on Sedation and Analgesia has been expanded to include assessment of pain and grading of sedation risk. Advances in understanding, new definition and current approach to ventilatory and other managements are included in the chapter on Acute Respiratory Distress Syndrome. Revised Brain Death Criteria are included in the chapter on Management of Death. The appendices on new guidelines on HIV prophylaxis after accidental exposure, brain death checklist, central line bundles and daily checklist have been added. All of these are in keeping with the basic philosophy of the book to provide practical guidelines on management of critically ill children. I would also take this opportunity to acknowledge contribution of all the former and current DM Pediatric Critical Care fellows (Drs Sasidaran, Govindappa, Ramesh Kumar, Karthi, Karthik, Saptrishi and Baalaaji through their suggestions on appropriateness of contents, helping with literature search, checking the contents and proof reading. It is hoped that new revised edition will continue to help pediatric trainees as well as pediatricians in practice to develop their skills in managing critically ill children.