Objective To study the prevalence and the main risk factors of neonatal asphyxia in southern Gansu province high-altitude area.Method From October 2016 to December 2016,clinical data of neonates born in eight hospitals of the region were analyzed.A uniform questionnaire was used to survey the maternal condition and family background.Univariate and multivariate Logistic regression analysis were used to determine the risk factors of neonatal asphyxia.Result A total of 183 newborns were born with asphyxia (mild 157 cases,severe 26 cases),and the incidence of neonatal asphyxia was 15.3％ (183/1 197).The multivariate Logistic regression analysis indicated that the risk factors included altitude less than 3 000 meters (OR =2.693,95％ CI 1.275 ～5.689),maternal fever (OR =2.986,95％ CI 1.163 ～7.666),prolonged labor (OR =2.925,95％ CI 1.112 ～ 7.691),fetal distress (OR =7.000,95％ CI 3.254 ～ 15.056),uterine inertia (OR =2.737,95％ CI 1.484 ～ 5.047),umbilical cord abnormality (OR =3.094,95％ CI 2.051 ～4.668),amniotic fluid abnormality (OR =2.033,95％ CI 1.230 ～3.361)and placental abnormality (OR =2.753,95％ CI 1.016 ～ 7.464).Annual household income more than 30 000 yuan (OR =0.452,95％ CI 0.297 ～0.687) was protective factor of neonatal asphyxia.Conclusion The incidence of neonatal asphyxia was high in the region,which was related to intrauterine and intrapartum factors.Antepartum monitoring and timely treatment should be strengthened to reduce the incidence of newborn asphyxia.