Abstract: Objective　To assess the factors influencing the therapeutic effects of INSURE technology in premature infants with respiratory distress syndrome (NRDS). Methods　The clinical data from 309 infants with NRDS treated by INSURE technology were retrospectively analyzed from Jan. 2000 to Dec. 2012. Results　In 309 infants with NRDS, 302 infants were cured and the cure rate was 97.7%. Twenty-one infants (6.8%) needed the reintubation for mechanical ventilation within 72 h. The difference in reintubation rate was statistically significant among infants with different gestational age (P<0.01). The infants with the gestation age ≤ 28 weeks had a significantly higher reintubation rate. According to whether the reintubation was performed, the infants were divided into success group and failure group. Compared to the success group, there were higher percentage of infants who had gestation age ≤ 28 weeks, birth weight <1000 g and severe NRDS, needed high dose and repeated use of pulmonary surfactant and oxygen therapy, and had higher mortality in the failure group had (all P<0.05). Conclusions　The INSURE technology can be effective in treatment of NRDS. Small gestational age, low birth weight, and severe NRDS are the risk factors for the failure of the INSURE technology.