The newborns with compromised hemodynamics and respiratory failure are on higher risks for multiple adverse outcomes. Care of these patients is a challenging issue. Traditional bedside physical examination can be misleading. The chest X-ray and/or chest computerized tomography are the main imaging tools in the diagnosis of lung diseases. In neonatal respiratory and hemodynamic compromise, a combined heart and lung evaluation may help to assess the organ functions. Recently, targeted neonatal echocardiography (TNE) and point-of-care ultrasound (POC-LUS) have been integrated into clinical care in NICUs. POC-LUS is a easy-to-learn, radiation-free, bedside, quick and repeatable diagnostic method that can be performed in the NICU at the bedside. LUS can reliably and accurately diagnose many neonatal pulmonary diseases such as respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTN), meconium aspiration syndrome (MAS), pneumonia, and pneumothorax.