Background: Neonatal respiratory distress syndrome (RDS) is a common and challenging neonatal morbidity. Reliable prediction of the condition can improve management. Fetal pulmonary artery (PA) Doppler indices were suggested for prediction. However, the findings of different studies are conflicting.Aim of the work: The present study aimed to assess the value of PA indices in the prediction of neonatal RDS in term babies.Subjects and methods: This prospective study included 120 women with singleton term pregnancy. Assessed Doppler indices for the main pulmonary artery included pulsatility index (PI), resistive index (RI), peak systolic velocity (PSV), and the At/Et ratio. Upon delivery, the newborn babies were examined for RDS signs (tachypnea, retractions, and/or nasal flaring).Results: Among the 120 delivered babies, there were 16 (13.3 %) with RDS. Comparison between neonates with RDS and neonates without showed significantly lower neonatal weight, higher pulmonary artery RI and PI, higher pulmonary artery PSV in neonates with RSD. Also, they had a significantly lower pulmonary artery at/et ratio when compared with normal babies. The pulmonary artery at/et ratio showed the best performance compared to other indices (sensitivity: 100.0 %, specificity: 50.0 %) at a cut-off (0.32).Conclusions: The present study documented reliable predictive value of PA hemodynamic parameters including RI, PI, PSV, and at/et ratio in predicting neonatal RDS in term babies.