Abstract: OBJECTIVE To investigate the pathogenic bacteria and the effect of surgical treatment in neonatal necrotizing enterocolitis, so as to provide basis for clinical treatment of newborn. METHODS Totally 95 children with NEC who were surgically treated at Xintai People’s Hospital from Sep. 2013 to Sep. 2018 were selected. The distribution of pathogenic bacteria in stool and blood samples was detected. According to the timing of surgery, they were divided into 51 cases in the early operation group and 44 cases in the late operation group were divided into two groups. According to the specific conditions of the children, intestinal resection-intestinal anastomosis, intestinal fistula or abdominal drainage were selected. The therapeutic effect andprognosis of the two groups were compared. RESULTS A total of 73 pathogenic bacteria were isolated from 95 children, of which 41 strains of Gram-negative bacteria accounted for 56.16%, mainly Klebsiella pneumoniae and Escherichia coli; 29 strains of Gram-positive bacteria accounted for 39.73%,dominating by Staphylococcus epidermidis and Staphylococcus aureus; 3 strains of fungi account for 4.11%. The resistance rate of K. pneumoniae and Escherichia coli to penicillin was 100%, to levofloxacin was less than 30%, and that of S. epidermidis and S. aureus to streptomycin and linezolid was less than 16%. The clinical efficacy of early operation group was significantly better than that in the late operation group（P＜0.05）. The postoperative complication rate was 7.84%（4/51） in the early operation group, significantly lower than that in the late operation group（P＜0.05）. The cure rate in the early operation group was 80.39%（41/51）, significantly higher than that in thelate operation group（P＜0.05）. CONCLUSION The main pathogens in children with neonatal necrotizing enterocolitis were Gram-negative bacteria. For children with surgical indications, early surgery can reduce the incidence of surgical complications and improve the cure rate.