Introduction: Surfactant is a heterogeneous mixture of lipids and protein and it is produced by type II alveolar epithelial cells, preventing alveolar collapse during expiration. Before 34 weeks of gestation the type II pneumocytes are not sufficiently formed and thus the risk of respiratory distress is high. This study has made an attempt to estimate the association of newborns with respiratory distress while using gastric aspirate Shake test. Objective: To estimate the association of newborns with respiratory distress while using gastric aspirate shake test (GAST) in Dr. Somervell Memorial CSI Medical college, Hospital, Karakonam from November 2018-November 2020. Method: This cross sectional study included 67 newborns delivered at a tertiary care Centre, for whom nasogastric tube insertion was indicated. Shake test was performed with 0.5 ml of the gastric aspirate and the entire babies with Shake test were assessed with Silverman Anderson retraction score. Results: Out of the 67 babies enrolled only 12 babies developed Respiratory distress using SA score. The distribution of gender showed that, there were 36(53.7%) males and 31(46.3%) females. The mean GA of the study population is 35.58(±1.86wks.). About 55 (82.1%) newborns were moderate PT. (32-37 wks.); 1(1.5%) was an early PT. (<32 wks.) and remaining 11(16.4%) babies were Term Babies (>37 wks.).Out of the total 67 babies observed only 12 had Respiratory Distress using SA Retraction score of 4-6 and 55 had no significant respiratory distress The Gastric Aspirate Shake Test was positive in 59 babies and negative in 8 babies. There was a significant association between the Respiratory distress p=0.011 and no significant association with Gestational age P=0.1. The Sensitivity, Specificity, Positive Predictive value (PPV), Negative Predictive Value (NPV) and Accuracy in Relation to Respiratory Distress Score was found as 66.67%, 7.27%, 13.56%, 50% and 17.91%. Conclusion: Although the Gastric Aspirate Shake Test is rapid, simple and inexpensive it may not be a ideal primary test in early diagnosis of respiratory distress and to provide necessary special attention in suspected cases of the same.