Abstract：Objective To investigate the clinical characteristics and risk factors associated with neonatal respiratory distress syndrome （NRDS） in 68 cases. Methods A total of 68 cases of NRDS admitted to Danyang Maternal and Child Health Hospital from June 2020 to September 2023 were selected as the observation group. Simultaneously, 150 healthy newborns examined at the same hospital during the same period were selected as the control group. The clinical characteristic indicators of the two groups were compared, and the risk factors inducing NRDS were analyzed. Results Compared with the control group, the observation group had a significantly higher proportion of newborns delivered via cesarean section, with meconium-stained amniotic fluid aspiration, birth asphyxia, intrauterine distress, and maternal gestational diabetes. The proportion of postnatal use of pulmonary surfactant （PS） was significantly lower in the observation group.  The differences between the two groups were statistically significant （χ2＝18.676, 34.069, 29.719, 32.384, 58.194, 15.446; all P＜0.001）. Additionally, the gestational age of the observation group was significantly smaller, and the difference was statistically significant （t＝8.247, P＜0.001）. Multivariate Logistic analysis identified independent risk factors for inducing NRDS, including cesarean delivery, meconium-stained amniotic fluid aspiration, birth asphyxia, intrauterine distress, and maternal gestational diabetes （OR＝2.328, 2.421, 2.368, 2.168, 2.145; all P＜0.05）. Gestational age and postnatal use of PS were identified as protective factors （OR＝0.443, 0.440; both P＜0.05）.  Conclusion Independent risk factors for NRDS include cesarean delivery, meconium-stained amniotic fluid aspiration, birth asphyxia, intrauterine distress, and maternal gestational diabetes, while greater gestational age and postnatal use of PS are protective factors. Therefore, targeted interventions based on these findings can be implemented to improve neonatal outcomes.