Background: The most common cause of mortality and neonatal morbidity in preterm and early term fetuses is lung immaturity. Respiratory distress syndrome (RDS) is a major cause of neonatal mortality and morbidity where the lung cannot provide sufficient oxygen. Objective: Evaluating the distal femoral, proximal tibial and proximal humeral ossification centres as predictive tools of fetal lung maturity. Patients and methods: This study was conducted at Obstetrics and Gynecology Department, Damanhur Teaching Hospital, from May 2019 to January 2020 and included a sample of 100 pregnant women. The mean age of mother in our study was 25.35±3.75 years, the mean BMI was 32.85±4.33. The mean gestational age by U/S was 38.01±1.65 weeks, the mean epiphyseal ossification centers was ranged from 2.4-6.8 with a mean of 4.53±1.22, and the epiphyseal ossification centres were parallel to gestational age. Results: The results of this study showed that the relation between Mean Epiphyseal Ossification Centers and neonatal Respiratory distress syndrome. The mean Epiphyseal Ossification Centers were significantly low in neonatal with respiratory distress syndrome (p <0.05). It was found that there was a positive significant correlation between mean epiphyseal ossification centers and APGAR score at 5 min. It was found that the Mean Epiphyseal Ossification Centers were significantly increased with increasing gestational age. Conclusion: The distal femoral, proximal tibial and proximal humeral ossification centers have good predictive values of fetal lung maturity.