Respiratory distress syndrome (RDS) is a condition of pulmonary insufficiency due to lack of lung surfactant and structural immaturity of the lung, and it occurs mainly in premature babies. Pulmonary insufficiency begins to manifest immediately at birth or within a few hours after birth and it progresses during the first two days of a newborn life. If proper treatment is not timely applied, death can occur due to progressive hypoxia and respiratory failure. Clinically, RDS is manifested by the occurrence of tachipnea, dyspnoea and apnoic crises, with activation of accessory respiratory muscules with exhalative grunting and central cyanosis. The diagnosis of RDS may usually be set in the first minutes or hours after delivery, based on patient history data on pregnancy and childbirth, clinical presentation, lung findings, gas analysis of the blood and the x-ray image in which the so-called. "Milk Lung" can be seen with a clearly expressed aerobronhogram. The development of prenatal and perinatal medicine has significantly reduced the mortality rate caused by RDS. Prenatal application of corticosteroids has been shown to accelerate the lung growth process and prevent the onset of the disease. Premature born babys, especially those under 32 weeks of gestation, should be born in centers where tertiary health care can be provided, which includes the capabilities and skills needed for stabilization and primary care, respiratory support and surfactant application. Until resently the "golden standard" in treating RDS was endotracheal intubation, surfactant application and mechanical ventilation. According to the latest guidelines of early application of nCPAP, it is possible to postpone, in a large number, and avoid mechanical ventilation. In newborns with milder RDS, recovery can be achieved without the use of surfactant if nCPAP is applied immediately after birth.