Background: Colour doppler of foetal pulmonary artery is non-invasive tool in predicting neonatal respiratory distress. Materials and Methods: This was a hospital based observational study conducted among 110 pregnant women who presented for institutional delivery in Department of Obstetrics & Gynaecology, Department of Radiodiagnosis & Department of Paediatrics Mahatma Gandhi Medical College & Research Institute, Pondicherry, India, over a period of two years from January 2021 to June 2022 after obtaining clearance from Institutional Ethics Committee & written informed consent from study participants. Results: In this observational study difference in proportion of foetal MPA Pulsatility index (PI), Resistive Index (RI), acceleration time/ejection time ratio (AT/ET), neonate oxygen support >24 hours, & APGAR score < 7 between neonate respiratory distress was statistically significant. Difference in proportion of PI between NRD is statistically significant with a p value < 0. 001. Difference in proportion of RI between NRD is statistically significant with a p value < 0. 001. Difference in proportion of AT/ET between neonatal RD is statistically significant with a p value < 0.001. AT/ET ratio had a sensitivity of 95.31 %, specificity of 93.48 %, PPV of 95.31 % & NPV of 93.48 % in predicting NRD. Difference in proportion of neonates requiring oxygen support >24 hours between NRD is statistically significant with p value < 0.001. Conclusion: Difference in proportion of neonatal pulmonary artery AT/ET between neonatal RD is statistically significant with a p value < 0.001. AT/ET ratio had a sensitivity of 95.31 %, specificity of 93.48 %, PPV of 95.31 %, & NPV of 93.48 % in predicting RD in neonates.