When tissue oxygenation is impaired, compensatory mechanisms occur, including a redistribution of blood flow in order to maintain oxygen delivery to vital organs, resulting in a fall in peripheral blood flow. Monitoring peripheral oxygenation therefore has potential benefits as it may provide an early warning of changes in the state of tissue oxygenation. Clinical assessments of the state of peripheral perfusion are common, and several physiological measurements have been described or used which are able to monitor peripheral oxygenation. Some of the available methods and their clinical implications will be reviewed. Near infrared spectroscopy is a particularly promising technique that has only recently been used in the preterm neonate to quantify peripheral oxygenation. It may be of potential value in understanding pathophysiological changes that occur in certain situations and needs further assessment to determine whether it may be useful to guiding clinical interventions.