Background: Cardiopulmonary resuscitation for infants is considered a lifesaving procedure and one of the basic and fundamental pediatric clinical skills. There is a necessity for simple teaching methods accepted by the students and provide a sustainable outcome.  Peyton's four- steps approach is a model for instructing practical skills and consisted of: -demonstration, -deconstruction, -comprehension, -and-execution. The study aimed to determine the effect of Peyton's four- steps approach on pediatric nursing students' skills acquisition, self-efficacy and satisfaction regarding infants' cardiopulmonary resuscitation. A quasi-experimental research design was used in the study. The study was accomplished at the Clinical Pediatric Skills Laboratory for third year students, Faculty of Nursing, Tanta University. A total sample of 100 pediatric nursing students participated in the study. Four tools were used to collect the data: sociodemographic characteristics of the studied students, cardiopulmonary resuscitation observational checklist, learning self-efficacy scale and learner Satisfaction in Learning Scale. Results: All students in the study group had satisfactory level of skills acquisition, high self-efficacy and high satisfaction level regarding infants' cardiopulmonary resuscitation, Conclusion: Peyton's four- steps approach was effective in improving pediatric nursing students' skills acquisition, self-efficacy and satisfaction. Recommendations: Incorporating the use of Peyton's four-steps approach as a teaching strategy for all practical skills in clinical pediatric skills lab.