Background: RDS was reported to be the most common cause of morbidity and mortality among preterm neonates.
Objective: This study aimed to evaluate the effects of postnatal intravenous ambroxol    for infant diagnosed with mild to moderate RDS.
Patients and methods: This study includes 40 preterm neonates, who were submitted to complete history taking, clinical examination, and initial investigations. All babies were followed up clinically, ABG testing, and x-ray imaging. All neonates in the intervention group (2^nd group), (20 cases) were received i.v. ambroxol    for 5 days beside routine RDS management, while the control group (1^st group), (20 cases) were received the routine management for RDS.
Results: There were non-significant differences between the two groups as regard sex, birth weight, residence (urban or rural) mode of delivery and gestational age (P-values 0.752, 0.825, 0.749, 0.749, and 0.548 respectively). There were non-significant differences between the two groups as regard Apgar score at 1 and 5 minutes (P-values 0.879, 0.871 respectively). After treatment, there were significant differences between both groups as regard PCO2 (mmHg), SaO2%, PaO2 mmHg. The need for M.V and CPAP and its duration, hospital stay, and death rate significantly decreased in neonates who received ambroxol.
Conclusion: Giving intravenous ambroxol to preterm newborns with RDS improves gas exchange and reduces the requirement for and duration of mechanical ventilation, CPAP, oxygen therapy, and overall hospital stay.