PURPOSE: We performed this study to evaluate the clinical efficacy and safety of dexamethasone in preventing laryngeal edema following exubation. METHODS: We retrospectively reviewed the medical records of 100 neonates who underwent endotracheal intubation and mechanical ventilation. Subjects were divided into two groups; dexamethasone treated (60 cases, dexamethasone group) and non-treated (40 cases, control group). We examined the underlying diseases of endotracheal intubation, and compared the two groups, change in respiratory rate before and after extubation, rate of reintubation, and duration of treatment (oxygen therapy before and after extubation, postextubation admission, and total admission). And also investigated adverse effects in dexamethasone group. RESULTS: Respiratory distress syndrome was the most common underlying disease of endotracheal intubation in both groups. The duration of endotracheal intubation and mechanical ventilation was significantly longer in the dexamethasone group (P<0.05), but there were no statistical differences in change of respiratory rate, rate of reintubation, duration of treatment between the two groups. In the dexamethasone group, hypertension (8 cases; 13.3%) and hyperglycemia (3 cases; 5.0%) were observed shortly and recovered without any treatment. CONCLUSION: There were no significant differences between dexamethasone group and control group of this study in clinical efficacy, so we concluded that the prophylactic use of dexamethasone for the prevention of laryngeal edema following short-term intubation has room for reconsideration in the neonates. Further prospective randomized double-blind studies are needed to understand the clinical effects of dexamethasone and to define apparent risk factors for postextubation laryngeal edema.