Abstract: Objective To compare the high risk factors, complications, treatment and prognosis of respiratory distress syndrome (NRDS) in neonates at different gestational age (GA). Methods Between August 2012 and July 2013, 156 neonates with RDS were selected and distributed into 3 groups, 42 early preterm (GA<34weeks), 52 late preterm (GA 35 to 36 weeks), and 62 in term group (GA ≥ 37 weeks). Retrospectively analysis was performed for high risk factors, complications, treatment and prognosis of the three groups. Results In 156 neonates with RDS, the male and female proportion was 2.25: 1. All groups had more males, but the gender difference has no statistical significance in three groups (P=0.923). The onset time of RDS and the hospitalization time both show an increasing trend of statistical significance (P<0.05). Comparing the difference of high risk factors for RDS of the 3 groups, birth asphyxia, placental abnormalities, multiple pregnancy, premature rupture of membranes was most common in early preterm group, and followed by late preterm group, and C-section was most common in term group and unexplained preterm was more common in early preterm group than that in late preterm group (all P<0.05). Among the three groups, the ratio of pulmonary surfactant application was the lowest in the term group, the ratio of X-ray grade over II was highest in early preterm group, oxygen and hospitalization time were the longest in early preterm group (P<0.05). The risks of complicated with pulmonary infection, intracranial hemorrhages and bronchopulmonary dysplasia were the highest in early preterm group and the risk of complicated pneumothorax was the highest in term group. Among three groups, the recovery rate was the lowest in the early preterm group (P<0.01). Conclusion The clinical characteristics, high risk factors, complications and treatment responses of RDS in neonates with different GA were different, so GA should be considered for diagnose and treatment. For the term infants, the elective caesarean section should be strictly controlled, in order to reduce the incidence of RDS.