Objective To explore the diagnostic value of lung ultrasound in neonatal respiratory distress syndrome. Methods: 2020.09 to 2022.09.30 children with respiratory distress syndrome were included.All children were examined by chest X-ray and lung ultrasound.The results of chest X-ray examination are gold standard.The child received PS (pulmonary surfactant) treatment.Analyze clinical related indicators.Results: Ultrasonography of the lungs of children with respiratory distress syndrome showed that there were differences between mild and severe cases.The severity of the disease could be evaluated by pleural effusion indicators.The results of X ray and lung ultrasound showed weak difference (P>0.05).Lung ultrasound has value in judging the efficacy of neonatal respiratory distress syndrome.Before treatment, 12 hours of treatment and 24 hours of treatment, LUS scores in both groups decreased, while those in the mild group were lower at each time period (P<0.05).Conclusion: In the diagnosis of neonatal respiratory distress syndrome, lung ultrasound can improve the diagnostic accuracy and provide effective guidance for follow-up treatment.