Objective: Magnesium sulfate (MgSO₄) administration to patients with preterm delivery has been associated with a decrease in cerebral palsy. At our institution, a protocol was established regarding the administration of magnesium sulfate for patients in preterm labor at less than 32 weeks of gestation. Despite this protocol, not all eligible patients received this therapy. The purpose of this study was to investigate potential barriers to MgSO₄ administration. Methods: A retrospective chart review was performed of those patients who received the diagnosis of “Early Onset Delivery” or “preterm labor” from January through December of 2010, to see what therapies were offered and received. Results: 119 patients met initial criteria. Of those, 68 patients had preterm labor less than 32 weeks. 15 of the 68 patients (22%) received MgSO₄. Of those patients that did not receive MgSO₄, only 6 delivered <32 weeks. Five were considered eligible. One patient had a relative contraindication to therapy. There were no demographic differences between those patients that received MgSO₄, and those that were eligible and did not. Potential barriers included short time frame from presentation to delivery, treatment not considered by healthcare provider, and unanticipated delivery. No patient declined therapy. Conclusions: At our institution, the rate of MgSO₄ administration for neuroprotection to eligible candidates was 75%. The subgroup of patients where MgSO₄ was not administered in eligible candidates was unanticipated delivery (4), and premature rupture of membranes (1). A 4 gram load of MgSO₄ should be attempted prior to delivery of eligible patients, as this strategy has also been shown to be of benefit.