When the typical fetal-to-neonatal circulatory transition fails as soon as the infant is delivered, persistent pulmonary hypertension of the newborn (PPHN) develops. PPHN, or persistent pulmonary hypertension of the newborn, is also known as the syndrome of inadequate circulatory acclimation. This has a significant impact on newborn morbidity and mortality. The prevalence is 2/1000 live births of infants. Most often, neonatal pulmonary diseases such meconium aspiration syndrome, congenital diaphragmatic hernia, and respiratory distress syndrome cause the pulmonary vasculature to relax slowly or inadequately, which leads to PPHN Objective: to describe meconium aspiration syndrome leading to PPHN.[1] Method: This study, which involved a 20-bed level III neonatal intensive care unit at a tertiary care institution at the DR. D.Y. Patil Medical College, Hospital and Research Center, Pimpri, Pune, was prospective and cross-sectional in nature. Term newborns with respiratory distress were assessed for PPHN in 160 cases out of the 1562 total admissions to the NICU over the course of two years. 90 instances did not progress to PPHN, five did not consent, and five patients had cyanotic heart disease. 60 patients in total were therefore enrolled. Perinatal information was gathered using a pre-filled proforma after receiving consent. Moreover, participants with gestational ages greater than 36 weeks plus 6 days, congenital heart disease, and other conditions were disqualified from the study. Conclusion: A key risk factor for PPHN is meconium aspiration syndrome. Hence, reducing the likelihood of meconium-stained amniotic fluid, which can result in meconium aspiration syndrome, can be achieved by avoiding perinatal foetal distress and encouraging vaginal birth.