Introduction: Neonatal mortality rate is an important index of development in different communities and respiratory distress syndrome is one of the important causes. This study aimed to determine the status and effective demographic  factors of neonatal mortality due to respiratory distress syndrome  in Rural Area of Ahvaz city Iran.
Method: It was a case control study of all neonatal death which had recorded health center rural area in Ahwaz city, Iran (54people) during 2010-2011 as case group. The control group (54 neonates alive) was selected as same birth date, age and residence for each case. Data was collected by a self-administrate questionnaire and interview with their mother to find the cause of death. All data has entered in spss software and analyzed by using chi-square, T-test.
Results: The results showed that neonatal mortality was for male 52.4% and female 47.6%. The most important causes of death were retard fetal growth (44.4%), respiratory distress syndrome (27.7%) and cardiovascular anomalies (16.6%). The findings reported significant correlation between neonatal mortality with, birth intervals and birth weight.
Conclusion: Improve pregnancy care, prevention of preterm deliveries, interventional programs for high risk groups, preparing the medical team for premature births and NICU equipment may have a critical role in reducing of neonatal mortality.