Abstract: Objective To observe the curative effects of high frequency oscillation ventilation combined with pulmonary surfactant in neonatal meconium aspiration syndrome. Methods The clinical data of 59 neonates with meconium aspiration syndrome was retrospectively analyzed. They were divided into observation group(high frequency oscillation ventilation combined with pulmonary surfactant based on routine treatment, n=33)and control group(high frequency oscillation ventilation based on routine treatment, n=26)according to different treatment methods. The changes of oxygenation indexes before and after treatment, improvement time of clinical indexes after treatment, and incidence of complications were compared between two groups. Results After treatment, the partial pressure of carbon dioxide in arterial blood ［p_a(CO₂)］, oxygenation index(OI)and fraction of inspiration oxygen(FiO₂)in two groups were significantly lower than those before treatment, the partial pressure of oxygen in arterial blood［p_a(O₂)］ was significantly higher than that before treatment, the p_a(CO₂), OI and FiO₂ in the observation group were significantly lower than those in control group, and the level of p_a(O₂)in the observation group was significantly higher than that in control group(P<0.05); the ventilator treatment time and hospitalization time in the observation group were shorter - than those in the control group(P<0.05); the incidence of complications in the observation group was lower than that in control group(P<0.05). Conclusion High frequency oscillation ventilation combined with pulmonary surfactant in neonatal meconium aspiration syndrome can effectively improve oxygenation index, shorten hospital stays, decrease the incidence of complications, and increase curative effects.