Abstract: Objective　To evaluate the effectiveness of intratracheal injection of pulmonary surfactant (LISA) combined with continuous positive airway pressure (CPAP) on the treatment of neonatal respiratory distress syndrome (RDS). Methods　 The databases of PubMed, EMBASE, Cochrane, China National Knowledge Infrastructure (CNKI), Wanfang Database, Weipu Database and China Biology Medicine disc (CBM) were searched, and all of the randomized controlled trial of LISA combined with CPAP for treatment of RDS were included. RevMan 5.2 was used to perform meta-analysis. The differences of mortality, bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), and other complications between LISA group and control group were compared in <34 weeks gestational age preterm infants with RDS. Results　Five randomized controlled trials were included with 759 infants in total. Compared with control group, the rate of mechanical ventilation (RR: 0.32，95% CI: 0.13-0.82) and the incidence of BPD (RR: 0.61，95% CI: 0.42-0.88) were significantly decreased in LISA group. There were no differences in mortality and the incidences of ROP, IVH, and PVL between two groups (P>0.05). Conclusion　The mechanical ventilation and the incidence of BPD is significantly reduced in the treatment of neonatal respiratory distress syndrome by LISA, but it has no effect on the incidences of other complications and mortality.