The clinical manifestations of neonatal pneumonia vary greatly and can usually be divided into three scenarios. The first scenario involves congenital pneumonia, which generally occurs within 24 hours after birth due to intrauterine infection. There is often a history of asphyxia, and after birth, the symptoms can include significant shortness of breath, moaning, cyanosis, and even respiratory distress. The baby may also exhibit unstable body temperature and poor responsiveness. The second scenario is pneumonia acquired during the delivery process. Typically, the clinical symptoms appear later, arising several days or weeks post-birth. It is usually characterized by reduced appetite, coughing, and varying degrees of fever. The third scenario is pneumonia acquired after birth, where onset is relatively sudden. Symptoms may include fever or hypothermia, frothy spit, phlegm, and in some cases, coughing. Generally, the responsiveness is relatively poor in these cases. Due to the large variety of clinical symptoms resulting from different types of infections at different stages, it is crucial to carefully distinguish between them and seek timely medical examination and treatment at a hospital.