Objective: To find out the frequency of necrotizing enterocolitis (NEC) in preterm infants and to compare the frequency of NEC in preterm infants with formula feed versus breast feed. Study Design: Cross-sectional study. Setting: Department of Pediatric Medicine, Ghazi Khan Medical College, Dera Ghazi Khan, Pakistan. Period: January 2022 to June 2022. Material & Methods: A total of 174 preterm infants were enrolled. The NEC was diagnosed as abdominal distention or intolerance to nasogastric feed with pneumatosis intestinalis / portal venous gas or free intraperitoneal air which was confirmed by abdomen X-ray. At the time of enrollment, gestational age and weight were recorded. All preterm neonates were called for follow up every week for 4 weeks to diagnose NEC. Results: Of these 174 study cases, 101 (58.0 %) were male patients while 73 (42.0 %) were female patients. Mean gestational age of our study cases was 30.48 ± 3.24 weeks. Of these 174 study cases, 102 (58.6%) mothers were illiterate. Breastfeeding was noted in 74 (42.5%) infants while formula feeding was recorded among 100 (57.5%) infants. The NEC was reported among 61 (35.1%) cases whereas NEC in breastfeeding cases was found in 14 (18.9%) and 47 (47.0%) infants with formula feeding. Conclusion: High frequency of NEC was observed among preterm infants given formula feeding in comparison to breastfed preterm infants. Significant linkage of NEC was noted with gender, maternal literacy, birth weight and pattern of feeding.