Background: Preterm neonates are at high risk of developing respiratory distress in the immediate post-natal period. Traditionally, these infants are managed by intubation and mechanical ventilation. The use of continuous positive airway pressure (CPAP) has gained immense popularity as a primary mode of respiratory support in these infants. Objective: To analyze indications of respiratory support, complications associated with each modality of respiratory support and short-term outcome. Patients and methods: This study included 100 neonates admitted to NICU, Pediatrics Department, Faculty of Medicine, Sohag University Hospital during one-year period. Their age ranged from 0-28 days with symptoms of respiratory distress, which were evident shortly after birth and requiring respiratory support. Results: The most common causes of admission were respiratory distress syndrome (RDS) 50%, sepsis 38%, asphyxia 8% and pneumonia 4%. Seventy two percent of the studied patients underwent CPAP, 14% oxygen support by nasal cannula and 14% mechanical ventilation. 82% of patients put on CPAP had improved and the failure rate of CPAP therapy was 18%. Adverse effects had occurred in 6 patients (42%) as: pneumothorax, ventilation acquired pneumonia and pulmonary hemorrhage. Mortality rate in ventilated babies in this work was 42.9%. Overall mortality rate in our study was 7%. Conclusion: CPAP was the most widely used and safe modality of respiratory support.