Sudden Infant Death Syndrome (SIDS) is characterized by the sudden death of an infant, unexpected by history and unexplained by a postmortem exam. The rate of SIDS has decreased markedly since the launch of the Back to Sleep campaign and other public health initiatives. Despite these efforts, SIDS remains the third leading cause of infant death and the leading cause of postneonatal deaths in the United States. The cause of SIDS is unknown, but autopsies have suggested that asphyxia and central nervous system abnormalities, among other findings, may play a role. Environmental risk factors, such as maternal smoking and infant sleep position, are multifactorial and documented throughout the medical literature. The influence of genetics on SIDS risk is not as well-understood at this time, but recent data have demonstrated associations between specific polymorphisms and SIDS, suggesting that interactions among environmental and genetic factors contribute to SIDS susceptibility. Recent data regarding the protective effects of pacifiers and breastfeeding are discussed. Risk reduction guidelines for physicians, parents, and other caretakers are outlined in this review of the literature, with particular emphasis on the 2005 recommendations from the American Academy of Pediatrics.