The Apgar score provides a rapid, standardized assessment of a newborn's condition at 1 and 5 minutes after birth. A score of 7–10 is considered reassuring and indicates that the infant is in good condition, requiring only routine care (drying, warming, and stimulation). A score of 4–6 suggests moderate depression; the infant may need additional interventions such as supplemental oxygen, tactile stimulation, or brief positive-pressure ventilation. A score of 0–3 indicates severe depression requiring immediate and aggressive resuscitation, including positive-pressure ventilation and potentially chest compressions, intubation, or epinephrine administration.

The 1-minute score reflects the infant's tolerance of the birthing process, while the 5-minute score better correlates with the effectiveness of resuscitation efforts and short-term outcomes. If the 5-minute score remains below 7, scoring continues every 5 minutes up to 20 minutes of life.

Use the Apgar timer at every delivery to ensure timely assessment at the standardized 1-minute and 5-minute intervals. The timer is particularly valuable in busy delivery rooms where multiple tasks compete for attention, helping the team remember to pause and formally score the newborn at the correct times.

The Apgar score is a universal standard of care endorsed by the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG). It is recorded for every live birth and is included in the medical record and birth certificate. Extended scoring (at 10, 15, and 20 minutes) is performed when the 5-minute score is below 7.

The Apgar score is a clinical snapshot and should not be used to predict long-term neurological outcomes or to diagnose birth asphyxia. A low Apgar score can result from many factors including prematurity, maternal medications (sedatives, anesthetics, magnesium), congenital anomalies, and normal physiological transition — not just hypoxia. The AAP and ACOG have explicitly stated that the Apgar score alone is insufficient to establish a diagnosis of asphyxia.

The score has inherent subjectivity, particularly in the assessment of color (appearance), reflex irritability (grimace), and muscle tone (activity). Inter-observer variability is well documented. In preterm infants, normal Apgar scores are generally lower due to physiological immaturity, and modified scoring criteria have been proposed but are not universally adopted. The score also does not replace continuous clinical assessment or more objective measures such as umbilical cord blood gas analysis.