Background: One of the most frequent causes of respiratory distress in newborns, particularly in late-preterm and term infants, is transient tachypnea of the newborn (TTN). It is brought on by a lag in the fetal alveolar fluid's postpartum clearance.
Objective: To study the effect of early epinephrine inhalation versus salbutamol inhalation on the outcome of transient tachypnea of newborn and hospital course of admitted cases.
Patients and Methods: A prospective randomized control study conducted at NICU during the period from December 2021 to May 2022. Study population: The current study involved include 150 neonates subdivided into three groups: Group A: 50 cases, infants in this group treated with conventional nasal canula, iv fluids, antibiotics and Ryle feeding. Group B: 50 cases, infants in this group treated as group A in addition to two doses of inhaled salbutamol 12 hours apart. Group C: 50 cases, infants in this group treated as group A in addition to two doses of inhaled epinephrine 12 hours apart.
Results: salbutamol group showed significant lower respiratory rate after treatment compared to control group and adrenaline group (p= 0.002 & 0.005 respectively). There was significant increase in PaO2 after treatment compared to before treatment in control group (p<0.001), adrenaline group (p<0.001) and salbutamol group (p<0.001), while there was significant decrease in PaCO2 after treatment compared to before treatment in control group (p<0.001), adrenaline group (p<0.001) and salbutamol group (p<0.001). it was observed that salbutamol group had significant lower hospital stay duration compared to control group (p=0.004) 
Conclusions: Inhaled salbutamol resulted in better outcome than epinephrine inhalation in decreasing the TTN clinical score, lowering the FiO2, increasing the O2 saturation and decreasing the duration of respiratory support along with the total duration of hospitalization.