Background: Respiratory distress (RD) is a common problem in newborns immediately following birth. It is often seen during the transition from fetal to neonatal life. Aims: This study was conducted to demonstrate the surgical causes of respiratory distress in infants admitted to paediatric surgical department of Benghazi Children Hospital and to describe the short term outcome of the sample. Methodology: A retrospective observational descriptive cross section study was done to achieve the aims of this study. Results: A sample of (50) children admitted with respiratory distress due to congenital anomalies, the age range of the sample was from one day to one year, male were (70%) and females and (30%). Residency (20%) from Benghazi and (80%) from outside Benghazi. Normal delivery was reported in52% of the cases and (48%) C/S, (86%) were born at term and (14%) preterm. The mean weight of the cases was (3.38) (±1.91) kg with minimum of (2) kg and maximum (10) kg. TOF in (52%), diaphragmatic hernia in (40%) and lung emphysema in (8%). Clinical presentation of the cases was mainly with respiratory distress in (84%), while (16%) presented with frothy secretion, ultrasound scan was done to (88%) and was normal. Echocardiogram was normal, atrial septal defect in (16%), ventricular septal defect in (14%), patent ductus arteriosus in (8%). (80%) were operated. Death was recorded in half of the cases. Cases with TOF were in total (26) cases of them (17) died and (9) survived, diaphragmatic hernia cases were (20), of them (12) discharged and (8) died, all cases of congenital lobar emphysema discharged. This association was highly significant Fisher`s (exact=6.9 P=0.005). all preterm neonate died (seven cases) and those who were term were in total (43) of them (25) survived and (18) died, Fisher`s (exact=10.85 P=0.005). Cases who were presented with respiratory distress were in total (42) of them (18) died and (25) discharged, while cases who presented with frothy secretions ....