Negative pressure ventilation (NPV) aids neuromuscular disease (NMD) patients facing respiratory failure. Revived by technology, NPV, including biphasic cuirass ventilation (BCV), uses external pressure for breathing assistance. BCV features varied modes, like controlled ventilation and high-frequency oscillation, when positive pressure ventilation fails. NMD’s respiratory muscle weakness reduces vital capacity, causing ventilation issues and potential aspiration. While airway obstruction is a concern, obstructive sleep apnea can contraindicate NPV. Patients may need continuous respiratory support, where NPV, alternated with other methods, helps, particularly for those intolerant to positive pressure. BCV facilitates breathing by oscillating or consistently applying negative pressure to the thorax. A piston pump supporting the flexible cuirass provides the pressure. This allows for better tidal volume but older NPV methods depend on natural recoil. The interfaces for NPV are the iron lung, poncho, and cuirass. Clinical uses involve treating acute or chronic respiratory failure, or for home ventilation. Studies have shown that Biphasic cuirass ventilation (BCV) can improve results. Overall, proper use of these depends on the proper treatment.