Background: The purpose of this study was to assess cardiac troponin T(cTnT) in neonates with respiratory distress as a marker of myocardial dysfunction.. Methods: : Total sample size 100 neonate , 50 neonates with RD and 50 healthy neonate (without RD) .. Serum cardiac troponin T was measured using ELISA technique. Results: the cardiac troponin T (CTnT) levels among our studied groups, We found CTnT levels were significantly higher (p < 0.001) in study group (RD cases )( 0.200±0.156 ng/ml) than in control group (healthy neonates ) (0.034±0.019 ng/ml) .Area under the ROC curve was 0.962 with best cutoff value(>0.056), sensitivity was 90%, specificity was 90%. Also, cTnT levels were significantly higher in neonates who required inotropic support when compared to those without inotropes. We found CTnT levels were significantly higher in cases who died than in cases who survived (p < 0.001). Conclusion: Cardiac troponin T is higher in neonates with respiratory distress compared to healthy infants. It could be used as a useful marker for myocardial dysfunction.