Nurses are often faced with the challenge of starting an IV line in a patient who is dehydrated, has suffered trauma, or is in shock. Even the efforts of the most skilled clinician may fail, while valuable time is lost. Intraosseous access is a rapid, safe, and effective route for delivering fluids and medications, and is recommended by numerous professional and specialty organizations for both pediatric and adult patients. Yet many clinicians remain unaware of the procedure. This article outlines the procedure and devices used, describes support for use in the literature, and discusses various considerations and nursing implications.