Respiratory syncytial virus (RSV) remains a significant cause of morbidity and mortality in infants, immunocompromised patients and the elderly. Despite the high disease burden, an effective vaccine or specific therapy are lacking which is largely due to our limited understanding of the immune response to RSV and how it relates to clinical disease severity. Current treatment for RSV remains largely supportive and RSV-specific options for prophylaxis and/or treatment are limited to palivizumab and ribavirin. There are a number of promising compounds currently under development, including new monoclonal antibodies and small molecules. These newer antivirals have the potential to impact both the prevention and treatment of RSV disease in the main target populations.