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 including 40 neonates with the diagnosis of PPHN who were admitted in NICUs in multi-centers from June 2014 to December 2014. Neonates divided into 2 equal groups one is treated by intravenous milrinone infusion and the other is treated by nasogastric sildenafil, it includes 33 males, 7 females; their mean gestational age was ±36.5weeks and the mean weight was 2.9 ± 0.5Kg. Results: Male neonates had higher incidence of PPHN 82.5% compared to females 17.5% .Neonates received intravenous milrinone infusion shows statistical significant improvement than those recived nasogastric sildenafil in oxygenation index (OI)values 24 hrs after treatment(p≤0.010), 48 hrs later (P≤ 0.001). Successful treatment was defined as drop of systolic pulmonary artery pressure (SPAP) below ≤40mmHg. There was statistical significant drop of SPAP after application of milrinone than sildenafil (P≤0.040). The mortality rate was 10/40 neonates (25%). Conclusion: Milrinone is better than sildenafil in duration to improvement of oxygenation index, shorting duration on ventilation and reducing PAP.