Background: Respiratory distress is the most frequent cause of admission in neonatal intensive care in both term and preterm infants. The clinical presentation of respiratory distress can vary from mild to severe respiratory distress requiring mechanical ventilation, and also depends on the respiratory support received before referral to a higher center. The etiology for respiratory distress depends on fetal, maternal, and environmental risk factors, and also on gestational age and birth weight. Objectives: This study was performed to assess and analyze the risk factors, etiology, clinical profile, morbidity, and mortality of neonates admitted with respiratory distress in NICU. Methods: This was a prospective study was done on 292 neonates admitted to Neonatal Intensive Care Unit (NICU) with respiratory distress. General information, socioeconomic status, detailed perinatal history, and clinical examination were documented. Results: 292 neonates admitted with respiratory distress were included in the study. Around 151 (51.7%) babies were born prematurely. The mode of delivery was LSCS in 254 (87.16%) neonates. The most important risk factors were delivery by Cesarian section and maternal infection (49%). Transient tachypnea of the newborn (45.2%), Congenital pneumonia (22.2%), and Late-onset sepsis (10.9%) were the most common causes of respiratory distress. 32.1% of these infants required respiratory support in the form of invasive and non-invasive ventilation. Only 3 infants (1.03%) of infants expired during the study period, due to severe RDS and late referral to the hospital. Conclusion: The most important risk factors for respiratory distress are delivery by Cesarian section and maternal infection. Early referral and early respiratory support help in better outcomes.