Body position enhances oxygen transport by the operational effect of gravity on cardiopulmonary and cardiovascular function. This study was aimed to investigate the effect of knee-chest, semi-sitting, and right lateral position on preterm neonates with respiratory distress syndrome. Subjects and Method: A quasi-experimental research design was utilized, and it was carried out at the Neonatal Intensive Care Unit at the Obstetric and Pediatric Minia University Hospital. A purposive sample was composed of 57 preterm neonates with respiratory distress syndrome. One tool was used, which included two parts: Preterm bio-demographic data and an assessment sheet for monitoring respiratory system functions. Results: The knee-chest position significantly improved respiratory rate, decreased heart rate, and increased oxygen saturation flowed by the right lateral position. Also, improvement of respiratory rate, heart rate, and oxygen saturation when using knee-chest position in the items of newborn age, gestational age, and birth weight at P-value Conclusion: Both knee-chest and right lateral positions effectively improve the respiratory system function among preterm neonates with respiratory distress syndrome compared to a semi-sitting position. Recommendation: Program education for neonatal nurses about applying for knee-chest position among incubated preterm infants with respiratory problems.