Background: To investigate the association between sex and neonatal respiratory distress syndrome (NRDS). Methods: Infants born at our hospital and transferred to the neonatal department within 1 hour were retrospectively analyzed. Depending on whether they developed NRDS during their hospital stay, the infants was divided into NRDS and non-NRDS groups. There were 142 infants in the NRDS group (95 males and 47 females) and 310 infants in the non-NRDS group (180 males and 140 females). The infants’ data on gestational age, sex, birth weight, white blood cell count (WBC), platelet count (PLT), C-reactive protein (CRP), immunoglobulin M (IgM), gestational diabetes mellitus(GD), antenatal steroids use, meconium-stained amniotic fluid, and preterm premature rupture of membranes(PPROM）were gathered. Results: 452 infant (265 males and 187 females) were involved for the purpose of collecting basic characteristic. Multivariate analysis, males had a 1.87 times higher risk of NRDS than females (P<0.05) after controlling for the confounding effects of gestational age, birth weight, WBC, PLT, CRP, IgM, GD, antenatal steroids use, meconium-stained amniotic fluid, and PPROM. Conclusions: Sex was associated with NRDS; males had a considerably higher risk of NRDS than females.