Abstract Objectives: To evaluate the effect of pulmonary surfactant (PS) administration on the prognosis of preterm infants after pulmonary hemorrhage. Methods: The study participants were preterm babies [gestational age (GA) <34 weeks] with pulmonary hemorrhage admitted from January 1, 2017 to December 31, 2022. The timing of administration is usually 2 - 4 hours after the pulmonary hemorrhage stabilizes. Accordingly, the participants were retrospectively divided into the PS administration group after pulmonary hemorrhage (n=16) and the non-PS administration group after pulmonary hemorrhage (n=40) according to the hospital information system. Results: By Multivariate analysis, PS administration after pulmonary hemorrhage did prolong the survival time [adjusted hazard ratio (HR) = 0.407, 95% confidence interval (CI) 0.173-0.955]. Conclusion: It suggests that PS administration after pulmonary hemorrhage is beneficial for improving the prognosis of preterm infants with GA < 34 weeks.