Neonatal respiratory distress syndrome (NRDS) is a significant cause of morbidity and mortality in preterm infants due to insufficient surfactant production in the lungs. This case report explores the effect of physical rehabilitation on oro-motor stimulation, manual airway clearance, positioning, and tactile stimulation (PROMPT) approach on a preterm neonate with NRDS. The report details the pre-natal, natal, and post-natal history of the patient, including maternal health, pregnancy complications, delivery specifics, initial clinical presentation, and subsequent management. Standard treatments such as exogenous surfactant administration and respiratory support were complemented with PROMPT techniques. The outcomes demonstrate the potential benefits of incorporating physical rehabilitation in the management of NRDS, highlighting improvements in respiratory function and overall clinical stability. This case underscores the importance of multidisciplinary approaches in enhancing the care and prognosis of neonates with NRDS.