Background: Enterocolitis necrotizing (NEC) is linked to oxidative stress and ischemical necrosis. Ischemia modified albumin (IMA) is an albumin produced by reactive oxygen species that develop during ischemia owing to albumin modifications. Aim: to assess the amount of IMA in NEC-diagnosed preterm babies and to compare their level of healthy control. Methods and Subjects: Group (A) comprised thirty preterm babies with NEC, (B) included a control group of thirty preterm babies. The NEC diagnosis was established by Bell's amended staging criteria and ELISA assessed serum IMA in all subjects. Results: There was a substantial difference between patients and control groups (group A and B) in gestational age, sex and weight. There was a substantial difference in IMA levels between patients and control groups (P<0.0001). The following have significantly unfavourable associations; NEC gravity and weight of patients (P < 0.0001) The severity of the NEC and the level of the haemoglobin (P < 0.00001), the seriousness of the NEC and the platelet (P < 0.00001). Significant negative associations existed between IMA levels, gestational age (P<0.0001) and IMA levels and weight (P<0.00001). The following connections have been significantly positive; IMA levels and onset age (P < 0.00001); and lastly IMA and NEC severity (P < 0.00001). Conclusion: During the course of the illness, the NEC is typically identified using clinical and abdominal X-ray evidence. Thus one of the greatest difficulties for the diagnosis and treatment of NEC was the lack of a consistent, accurate and early marker of intestinal inflammation in the peripheral blood. In addition to radiological studies, the diagnosis of NEC does not include accurate biochemical assays in clinical practise. The present research shows that IMA may be involved in NEC's early diagnosis.