Preterm infants are at risk for respiratory distress syndrome which defined as a breathing disorder resulting from lung immaturity.Respiratory distress syndromeis a life-threatening lung disorder that results from underdeveloped and small alveoli and insufficient levels of pulmonary surfactant. Quality improvement is a major focus of neonatal health care. The present study aims to assess quality of nursing care provided to preterm infant with respiratory distress syndrome. A descriptive research design was utilized on48 neonatal nurses and 71 preterm infants. The nurses were working in the neonatal intensive care units of El-Nasr, El-Tadamon, and Port-Fouad General hospitals in Port Said City. The data were collected using an interview questionnaire sheet for nurses and assessment data sheet for preterm infants. The study's results indicated that, less than two-thirds of the studied nurses had poor level of knowledge and more than half of them had poor level of practice. There was a highly statistical significant relation between the studied nurses' total knowledge mean scores and total practice mean scores with their educational level with p ≤ 0.001. The study concluded that there was a highly statistical significant correlation between the studied nurses' total knowledge mean scores and their total practice mean scores. It was recommended that educational and training programs should be provided to neonatal nurses to improve their level of knowledge and practice through multidisciplinary approach that focus on the quality of nursing care provided to high risk neonates.