Advances in perinatal care have made it possible to improve survival of infants with low birth weight. The aim of study was to analyse the clinical impact of respiratory disease in premature infants with low birth weight. Methods: Between January-2011 and November-2012 were included 81 preterm infants with low birth weight and ≤32 weeks gestation. Data are expressed in according to birth weight defined as: extremely low <1000 g (ELBW), very low 1001–1500 g (VLBW) and low weight 1501–2000 g (LBW). Results: 84.8% of preterm infants received respiratory support by CPAP and in 46 cases (56.8%) was explained by mechanical ventilation. Endotracheal surfactant was administered in 34 infants (42%). Only 3 preterm did not require oxygen. 86.4% of infants with less than 28 weeks required mechanical ventilation compared to 45.8% of infants >28 weeks gestation. The incidence of morbidities such as bronchopulmonary dysplasia, pulmonary haemorrhage and pneumothorax was very low: 6.2%, 4.9% and 1.25%, respectively. The mean number of days requiring mechanical ventilation and treatment with caffeine for apnea was higher for ELBW compared to VLBW and LBW (6.7 ± 5.5 vs. 4.1 ± 4.7 vs. 3.38 ± 2.7, p = 0.023 and 38.1 ± 7.3 vs. 26.8 ± 15 vs. 12 ± 7.8, p = 0.01, respectively). The onset of bronchopulmonary dysplasia occurred in 5 preterm with ELBW. In all preterm infants who died required mechanical ventilation vs. who those survived 14 (100%) vs. 32 (47.8%), p = 0.001 and greater need of surfactant 10 (71.4%) vs. 24 (35.8%), p = 0.047. Conclusions: Although the most preterm with low birth weight require respiratory support, the incidence of complications in our series is low.