Introduction: En caul delivery , where a newborn is delivered completely enclosed within theintact amniotic sac, is a rare and striking obstetric event, occurring in approximately one in eighty thousand births and more often in preterm and caesarean deliveries. While the intact sac may offer brief protection from mechanical trauma and cord compression, it can delayimmediate access to the airway . In very preterm infants, even short delays in ventilation and thermal care can compromise early physiological adaptation. Case presentation: A 30-week preterm infant with antenatal oligohydramnios, weighing 1.46 kg, was delivered by emergency caesarean section completely enclosed within the amniotic sac. The neonatology team promptly opened the sac, exposing the face and chest first, placed the infant in a polythene wrap, and transferred the baby under a radiant warmer to secure the airway and access the umbilical cord. At birth, the infant had poor respiratory effort with bradycardia. Standard neonatal resuscitation was initiated with airway positioning and positive pressure ventilation, while strict thermal protection and continuous monitoring was ensured. Following initial stabilization baby transferred to the neonatal intensive unit forongoing supportive care. Conclusion: Preterm En caul delivery represents a high-risk birth scenario that demands calm, coordinated action. Anticipation, clear communication, and protocol-based care are essential to minimize hypoxia, hypothermia, accidental cord injury , and delays in life-saving interventions during the first critical minutes after birth. Therefore, En caul delivery is a timecritical situation that requires anticipation, team readiness, and adherence to neonatal resuscitation protocols to ensure a safe transition to extrauterine life.