 Objective. This study intents to develop a method of minimally invasive surfactant therapy followed by early CPAP MISTCPAP in preterm Infants with high risk of RDS for improving the outcomes and reducing the incidence of BPD. We propose a prospective randomized controlled trial to compare the MISTCPAP technique with the INSURE technique of surfactant administration, which involves intubation solely for the purpose of surfactant administration followed by immediate extubation to CPAP. The outcome of this trial could declare the effect of the intubation and positive pressure ventilation on the effectiveness of surfactant therapy. 