Context: A neonatal respiratory distress syndrome occurs at or soon after delivery (<24 hours). Premature newborns with respiratory distress syndrome (RDS) often need breathing assistance. There has been a tendency to reduce in the previous decade the use of non-invasive ventilation modes (NIV) in neonatal intensive care units to prevent ventilator-induced lung damage, in particular after recent data showing NIV in preterm babies has equivalent efficiency compared to EMV. In practical practise, different forms of NIV may be employed include nasal continuing positive airway pressure and noninvasive intermittent positive airway pressure. Nasal continuous positive airway pressure is one of the most often utilised non-invasive techniques (NCPAP). Although HFV has been used in several neonatal critical care units, a relatively novel modality of nasal high frequency oscillatory ventilation (nHFOV) is limited in evidence of its utility. The objective of this research has been to examine the effectiveness and safety of nasal oscillatory ventilation with nasal airway continuous pressure in preterm baby respiratory distress syndrome therapy. Methods: This research is a (60 instances) clinical experiment conducted with respiratory distress syndrome (admitted to the Benha University Hospital Neonatal Intensive Care Unit and Benha Kids Hospital) between the 1–28 day age range. Cases were randomly picked in two groups: Group I: 30 instances of high-frequency oscillatory nasal ventilation were treated (nHFOV). Group II: 30 individuals with constant nasal airway pressure were treated (NCPAP). Methods: Detailed history of medicine. Total usage time NHFV and NCPAP usage time and oxygenation time required for each instance. Complication detection occurs during non-invasive breathing (pulmonary air leak syndrome, IVH, nasal injury and other.) Studies of imagery. Outcomes: There was no statistically significant difference in demographic data between the two groups. There was a statistically significant difference in IVH complication between Group I and Group II. The percentage of nasal septal injuries in Group I was significantly lower than in Group II. The rate of intervention failure (intubing and ventilator demand) in Group I was significantly lower than in Group II (3.3 percent, (26.6 percent) p value=0.030. Conclusion: High frequency nasal ventilation has a greater impact than continuous airway pressure on infants and is less complicated. This research revealed that the length of non-invasive respiratory support was greatly shortened by high frequency nasal ventilation and the necessity for intubation was minimised compared to the continuous positive airway pressure of RDS infants.