Introduction: Long term noninvasive ventilation has been increasingly considered as a treatment option for children with OSA when adenotonsillectomy has failed or is contraindicated.Objectives: To describe our experience in long term CPAP & BPAP therapy in Thai children with OSA.Methods: This was a retrospective hospital record review and telephone interview of 71 children with OSA being on home CPAP or BPAP under the care of Pediatric Pulmonary Division, Ramathibodi Hospital between 1995 and 2014.Two patients were loss to follow-up and excluded.Demographic and clinical data were collected on the underlying diagnosis, ventilator related issues and outcome.Results: Of 69 patients, 51 (74%) were male, age at starting CPAP & BPAP was ranged 1.7 to 15.8 years.Eleven (16%) were under 5 years of age, 24 (35%) were under 10 years of age.The most common co morbidity was obesity (BMI ≥ 95 percentile for age) in 67 (97%) patients.15 (22%) patients had PraderWilli syndrome, 9 (13%) had corpulmonale and 6 (8.7%) had hypertension and or DM.Twelve (17.4%) stopped CPAP or BPAP due to clinical improvement.Fifteen (22%) were non-compliant.Four (5.8%) patients died from respiratory failure.The maximum duration of CPAP or BPAP was 11 years.The only reported complication was minor facial injury in 9 (13%) patients.Conclusion: CPAP & BPAP are well tolerated with minimal complications by most Thai children with OSA.