Background : Pulmonary hypertension in newborn (PPHN) is a critical problem facing neonatologists. Aim of the work : To determine the impact of management strategies on the outcome of PPHN. Patients and Methods : Prospective descriptive study. 40 neonates with the diagnosis of PPHN who were admitted in NICUs in children hospitals, Cairo University from January 2009 to April 2009. The study included 23 males, 17 females ; their mean gestational age was +37 or-25 weeks and the mean weight was 2.85 + or- 0.95 Kg. Results : Male neonates had higher incidence of PPHN and higher mortality rate compared to females [7/23 (30.4%) versus 1/17 (5.9%), P≤0.05]. The LBW neonates had longer stay duration on mechanical ventilation (r=0.4, P≤0.05). IDM had high incidence of mortality rate (P≤0.003). There was statistical significant improvement of mean of the following components of the blood gases ; PH, PCO2, HCO3 after completion of the different lines of treatment. Successful treatment was defined as drop of systolic pulmonary artery pressure (SPAP) below ≤ 40 mmHg. There was statistical significant drop of SPAP after application of different modalities of treatment (P≤ 0.001). Sildenafil was also effective in decrease length of NICU stay when used as an adjuvant therapy to neonates with PPHN. Neonates with PPHN on inotropic support had shorter duration of hospital stay. The mortality rate was 8/40 neonates (20%). Conclusion : Conventional therapy is effective in the management of PPHN with acceptable mortality. Oral sildenafil as an adjuvant to conventional therapy is more effective in reduction of pulmonary artery pressure and improvement of oxygenation.