Background: Premature newborns are the main victims of respiratory distress syndrome (RDS), commonly referred to as hyaline membrane illness. It happens when premature babies' lungs don't contain enough surfactant. The present study was conducted to assess use of aerosolized Ambroxol in the management of respiratory distress syndrome. Materials & Methods: 70 preterm infants of both genderswere divided into 2 groups of 35 each. Group I patients received an intravenous infusion of 30 mg/kg of Ambroxol for two days after receiving an injection of 15 mg/kg in the umbilical vein as soon as they were born. Group II received an aerosolized Ambroxol treatment, which involved inhaling 30 mg/kg of Ambroxol for two days right after birth. At the initial assessment, parameters such the enrolled newborns' temperature, heart rate, respiration rate, and SaO2 and mortality ratewere measured. Results: The mean respiratory rate in group I was 63.4 cycles/min and in group II was 66.8 cycles/min. The mean heart rate in group I was 146.3 beats/ min and in group II was 144.6 beats/min. The mean temperature in group I was 36.8 degrees C and in group II was 36.2 degrees C. The mean SaO2 in group I was 95.3% and in group II was 95.8%. The incidence of RDs was seen in 18 in group I and 13 in group II patients. 21 patients in group I and 14 in group II required mechanical ventilation. Mortality was 5 in group I and 11 in group II. Conclusion: Ambroxol can be atomized or given intravenously to premature babies, however atomizing or breathing is more effective than intravenous Ambroxol at preventing respiratory distress syndrome.