Background : Acute respiratory diseases are common neonatal conditions leading to neonatal intensive care unit admissions (NICU). Noisy respiration with increased work of breathing, persistent need for respiratory assistance and persistent radiological opacities prompts evaluation by fibreoptic flexible bronchoscopy (FFB). FFB has several benefits in neonates, however, this modality is not widely used due to lack of expertise or non-availability of equipment. We present our 7 years of experience with neonatal FFB. Methods : A retrospective, medical chart search study was conducted at a tertiary care multispecialty hospital, in neonates who underwent FFB over a period of 7 years (2011-2017). Results : Total 88 bronchoscopies were performed in 83 neonates admitted in the NICU. Median birth weight and gestational age were 2600 grams (range 820- 3660) and 37 weeks (range 26-41). Median age at the time of FFB was 27.5 days (range 1-152). While 51 procedures were done transnasally, 37 bronchoscopies were done through endotracheal tube. Most common co-morbid condition noted was congenital heart diseases (20.4%). Indications included persistent oxygen requirement (32/88) lung collapse (21/88), stridor (27/88), extubation failure (4/88), recurrent apnea (2/88) and suspected airway anomaly (2/88). Tracheobronchitis (8/32) and tracheobronchomalacia (8/32) were the common findings in neonates with prolonged oxygen requirement. Most common cause of stridor in neonates was laryngomalacia (16/27) followed by subglottic stenosis (4/27). Myriad of congenital airway anomalies could be diagnosed by FFB including laryngomalacia (18/88) choanal atresia (4/88), laryngeal cleft (4/88), tracheoesophageal fistula (TEF) (4/88), and one each of pyriform stenosis, laryngeal web, vocal cord paresis, absent tracheal ring and complete tracheal rings. Radiological improvement was seen in 17/21 (80.9%) cases of lung collapse after FFB. Bronchoalveolar lavage was done in 52 procedures, and microbiological yield was obtained in 16 (30.7%). Change in medical management by either, adding systemic steroids or changing antibiotics, after FFB was done in 35/88 occasions. Surgical intervention were undertaken in 15 cases (17%), including tracheostomies (9/15), TEF repair (4/15), lateralization of vocal cord (1/15), excision of laryngeal web (1/15). Transient hypoxemia was seen in (4/88) occasions while 83/88 cases did not suffer any complications. Conclusion : Airway anomalies are common in newborns and their early detection by FFB can be beneficial for optimum management. FFB can be used as an important diagnostic tool that can guide medical and surgical interventions in NICU.