This qualitative descriptive research investigated the current practices and perspectives of certified music therapists (MTA) working in neonatal intensive care units (NICUs) in Canadian hospitals. The Canadian context is important to consider because of this country’s unique healthcare landscape, and because the use of NICU music therapy in Canada is relatively new. Three individual interviews were recorded, transcribed, and analyzed according to qualitative content analysis procedures. Results include nine overarching categories containing multiple themes. These categories include: weekly workload, referrals, assessment, evaluation, music therapy interventions, challenges of the job, rewards of the job, evolution of NICU music therapy practices, and recommendations for advancing Canadian music therapy practices. Implications for the music therapy profession, practice and continuing education, as well as implications for Canadian hospitals and recommendations for research are presented. Limitations of the study are identified. It is the researcher’s hope that this study will help to promote the development of Canadian NICU music therapy programs, thus increasing Canadians’ access to this type of innovative service.