Aim: The objective of the present study was to predict neonatal respiratory distress by evaluating the colour doppler of the foetal pulmonary artery. Methods: This was a hospital based observational study conducted among 100 pregnant women who presented for institutional delivery in Obstetrics ward, Department of Paediatrics over a period of two years after obtaining clearance from Institutional Ethics Committee & written informed consent from study participants. Results: 40 (40%) participants were < 2.25 & remaining 60 (60%) participants were > 2.25 Pulsatility index of pulmonary artery. 40 (40%) participants were < 0.9 & remaining 60 (60%) participants were > 0.9 Resistive index of pulmonary artery. 42 (42%) participants were < 0.305 & remaining 58 (58%) participants were > 0.305 AT/ET ratio of pulmonary artery. 60 (60%) participants required neonate oxygen support > 24 hours. AT/ET ratio had sensitivity of 95.31% (95% CI 86.91% to 99.02%) in predicting respiratory distress. Specificity was 93.48% (95% CI 82.10% to 98.63%), false positive rate was 6.52% (95% CI 1.37% to 17.9%), false negative rate was 4.69% (95% CI 0.98% to 13.09%), positive predictive value (PPV)was 95.31% (95% CI 86.91% to 99.02%), negative predictive value (NPV) was 93.48% (95% CI 82.1% to 98.63%), & total diagnostic accuracy was 94.55% (95% CI 88.51% to 97.97%). Foetuses with MPA PI < 2.25, 2 (5%) developed no respiratory distress & foetuses with MPA PI > 2.25, majority of 57 (95%) developed respiratory distress. Difference in proportion of PI between neonate respiratory distresses was statistically significant (P value < 0.001). Foetuses with MPA RI < 0.9, 2 (5%) developed no NRD & foetuses with RI > 0.9, majority of 57 (95%) developed NRD. Difference in proportion of RI between neonate respiratory distress was statistically significant (P value < 0.001). Conclusion: The Study found that all parameters, pulmonary artery RI, PI, & AT/ET ratio showed good performance as predictors of RD development in neonates. It is recommended that a foetus with AT/ET <0.305 be delivered in a well-equipped hospital with respiratory support facilities, as it is at risk of developing neonatal RD