Background: - Meconium aspiration syndrome (MAS) is a life-threatening respiratory diseasernoccurring when neonates aspirate meconium-stained amniotic fluid near or around birth withrnvarying severity. An average of 8% to 25% live birth neonates with meconium-stained amnioticrnfluid have delivery complications and from these around 5% of them develop MAS with a 50%rnchance of needing for mechanical ventilation. There is a paucity of literatures in the study arearnregarding the study topic. Therefore, the study aimed to assess the prevalence and associated factorsrnof meconium aspiration syndrome among neonates admitted in NICU of governmental hospitals inrnAddis Ababa Ethiopia.Methods: - An institutional based retrospective cross-sectional studyrndesign was employed to collect data from February to Mach 2021. A three-year chart review fromrnJanuary 2018 to January 2021 was conducted. The data was collected by using structuredrnquestionnaire. Systematic random sampling technique was used to involve the estimatedrnstudy participants (268). Factors associated with meconium aspiration syndrome were determinedrnusing bivariate and multivariate logistic regression models. Statistically significant associationsrnwere declared at P value less than or equal to 0.05.Result: The findings from this study revealedrnthat 30.6% were diagnosed to have meconium aspiration syndrome. Factors associated withrnmeconium aspiration syndrome included being post term (Adj OR=17.548 95% CIrn(2.894,106.413)), first minute APGAR score of 7-10 (Adj OR=17.548 95% CI (2.894,106.413)),rnduration of labor from 12-24 hour (Adj OR=4.98 95% CI (1.677, 14.792)) and maternal bloodrngroup of AB (Adj OR=0.118 95% CI (0.029, 0.470).Conclusion and recommendation: In thisrnstudy almost 1/3 of the neonates had developed meconium aspirarion syndrome which indicatesrnfor the initiate delivery before 40 completed weeks of gestation and anticipation of neonatalrnresuscitation for neonates born from blood group of AB mothers. Key words: -MAS, neonate,rnrespiratory distress and MASF.