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Home heated humidified high-flow cannula therapy (HHHFC) is expensive and not always available. Domiciliary non-invasive ventilation (NIV), even in CPAP mode, may be poorly accepted by young non-collaborative patients and their families, due to interface problems or to leakage. Objective: to report our experience with HHHFC at home in young children. Methods: we tested a home CPAP equipment used with nasal cannulas to administer a high flow mixture of air and oxygen, humidified and warmed, as respiratory support in children with poor NIV acceptance and compliance. Gas flow for any pre-fixed CPAP level between 4 and 20 cmH2O was measured, with or without oxygen supplementation. Results: HHHFC therapy was applied to 9 pediatric patients, 4 females, mean age 12 months (range 2-45), mean follow up time 17.4 months (range 0.5-37), as home respiratory support during sleep time and respiratory exacerbations. Mean level of applied CPAP was 8.4 cmH2O (range 6-16), mean airflow measured was 7.8 L/min (range 6.3-11.85), which represented between 0.8 and 1.4 L/min/kg. HHHFC therapy was well tolerated and no side effects were reported. Reductions in number of hospital admissions, unscheduled visits and episodes of acute respiratory failure were observed. Sleep respiratory disorders improved in two patients. Feeding by nasogastric tube was not affected. Families felt that HHHFC respiratory support improved the quality of life of their children. Use of HHHFC was discontinued in two patients, was combined with NIV in four and continued with no changes in three. Conclusions: HHHFC therapy, when performed with CPAP devices, in selected patients, may offer the advantage of efficacy with a better tolerance than NIV.