Introduction: Respiratory distress (RD) in neonates is one of the important clinical manifestations of a variety of disorders of the respiratory system and non-respiratory disorders. The high percentage of babies with respiratory distress is because babies have minimal respiratory reserve and they can encounter numerous problems in transition from intrauterine to extra-uterine life. Methodology: All the babies born at or referred to NICU of Hospital during the neonatal period of (0-28) days of birth and meeting the criteria for case definition were included in the study. Sample size 150 consecutive newborns with respiratory distress were considered as cases for this study. Results: None of the clinical features were significantly associated with outcome in neonates with pneumonia except respiratory rate  60/min. Conclusion: Chest retraction and tachypnea had high sensitivity. Grunting, lethargy, poor feeding & hypothermia had high specificity.

Keywords: Respiratory Distress; Neonatal Pneumonia; Poor Feeding & Hypothermia.