Intraosseous (IO) infusion is a long existing method to obtain vascular access and has gained renewed interest over the last decade. IO infusion is an easy, safe, rapid and effective alternative method for vascular access in emergency clinical care and prehospital situations. The IO access can be used for administration of fluids, medication, analysis of electrolytes, blood type and blood gasses. The proximal tibia is the most common insertion location. New IO needles (F.A.S.T.1., Bone Injection-Gun and EZ-IO) have been developed over the last decade, to make insertion easier. Guidelines such as the ATLS and ERC are changing and currently recommend the use of IO needles in the emergency setting, in trauma and non-trauma situations, in both children and adults as alternative for peripheral vascular access. This will increase the use of the IO needles in de future. Awareness of indications, contra-indications and complications should therefore be enhanced.