Aim of the study: this study aimed to determine the role of prostaglandin E1 on the reduction of the neonatal respiratory morbidity specially (TTN). Study Design: this is a parallel, randomized placebo controlled trial, comparing the use of Misoprostol (Prostaglandin E₁) use in the form of Misoprostol E₁ vaginal tablets with nonmedicated similar vaginal tablet (placebo) to decrease the neonatal respiratory distress specially (TTN). Results: thisstudy included 300 cases with gestational age range between 38 weeks to less than 39 weeks the included cases were classified into 2 groups: study group included 150 case were given PG E1 control group included 150 case were given placebo. Conclusion: we found one positive cases for TTN in study group, and 3 positive cases for TTN in the control group results we got were insignificant. So, we suggested taking more large sample in the future studies.