PROMPT has generated significant literature and research into the recognition and management of shoulder dystocia. Including evidence underpinning the multi-professional training needed in this time critical emergency. This chapter covers risk factors, recognition, manoeuvres, complications and postnatal care required in a case of shoulder dystocia. Key learning points: Understand that shoulder dystocia is unpredictable, and therefore difficult to prevent. Health professionals should be vigilant at every birth. Understand that during shoulder dystocia, routine traction should be applied in an axial direction. Be able to perform the manoeuvres required to release the shoulders during shoulder dystocia. If a manoeuvre is unsuccessful, move straight to the next release manoeuvre - do not delay by continuing for 30 seconds. Neonatal outcomes, including brachial plexus injury (BPI), can be improved through multi-professional simulation training. Shoulder dystocia can lead to neonatal hypovolaemia; consider this possibility if the baby does not respond to initial resuscitation. Understand the importance of clear and accurate documentation, ideally using a standard proforma.