Beta (beta)(2) adrenergic receptors are present in alveolar type II cells. Previously, the beneficial effects of inhaled salbutamol treatment on respiratory outcomes were shown in premature infants with transient tachypnea of the newborn. We hypothesized that inhaled salbutamol would increase the effects of surfactant on oxygenation in premature infants with respiratory distress syndrome (RDS). Inhaled salbutamol (0.15 mg/kg) or normal saline solution (0.30 ml/kg) was administered as a single dose by micropump nebulizer 10 minutes before the first dose of surfactant (Poractant alfa) treatment in 40 infants with gestational ages ranging from 26 to 36 weeks. The effects of salbutamol therapy were evaluated by determining the duration of respiratory support, number of doses of surfactant, respiratory rate, heart rate, fraction of inspired oxygen, and partial pressure of arterial oxygen before and after salbutamol nebulization. No statistically significant difference was detected between the two groups in duration of respiratory support, number of doses of surfactant, respiratory rate, fraction of inspired oxygen, or partial pressure of arterial oxygen. In this study, no significant effect of inhaled salbutamol treatment on the surfactant therapy in premature infants with RDS was detected.