The purpose of this review of literature was, first, to examine whether the existing scientific evidence supports a recommendation for delivering rescue breaths during a swim rescue in the water and second, to examine which lifeguarding agencies are actually training their lifeguards in rescue-breathing procedures to use while performing a swim rescue. Among the North American aquatic-agency programs examined for this review were the American Red Cross, the Young Men’s Christian Association, the United States Lifesaving Association, the Canadian Lifesaving Society, Starfish Aquatics Institute, and Ellis & Associates. The authors conclude that it is evident that strong support exists in favor of the practice of in-water rescue breathing among aquatic professionals and within the medical community.