Objective??To investigate the risk factors in the outcome of neonatal pulmonary hemorrhage. Methods A total of 69 cases of neonatal pulmonary hemorrhage from January 2005 to December 2011 were studied. They were divided into 2 groups according to clinical outcome (death or alive). The data of the two groups were compared using single factor analysis. The risk factors were analyzed using multi-factor analysis. Results The death of neonates with pulmonary hemorrhage was correlated with aspiration pneumonia, coagulation abnormalities, DIC, heart failure and MPV. Multi-factor analysis showed that DIC (OR=6.90, 95%CI: 1.514-31.419), heart failure (OR=9.62, 95%CI: 1.710-54.150) and MPV <11 prior to pulmonary hemorrhage (OR=7.01, 95%CI: 1.475-33.312) were the independent risk factors of neonatal pulmonary hemorrhage. Conclusions For the neonatal pulmonary hemorrhage with DIC, heart failure and low MPV, active intervention should be implemented.