89 nonvigorous neonates with meconium stained liquor were followed in the immediate neonatal period. 41 neonates received endotracheal tube (ET) suctioning at birth and 48 neonates did not receive ET suctioning at birth. Of the 41 ET neonates 16 had meconium related morbidity /mortality at NICU stay and 25 was normal. Of the 48 non ET neonates 9 had meconium related mortality /morbidity, 39 were normal. Odds ratio of mortality/ morbidity is significantly high (2.77)in ET group with narrow confidence interval (1.063,7.234),P value 0.03.Relative risk of ET group of having nonfavorable outcome is 1.7.Tracheal suctioning of meconium in nonvigorous neonates at birth did not decrease the meconium related morbidity /mortality during NICU stay.