Given the current understanding and the inconsistencies in findings, our study aimed to explore the hypothesis proposing a correlation between ABCA3 rs170447 (c.1741+33T>C), rs323043 (c.1755G>C), and rs13332514 (c.1059G>A) variants and the likelihood of neonatal RDS development, as well as overall survival within the Romanian population. Here, ABCA3 is linked to newborn respiratory distress syndrome.