Objective To compare the plain X-ray radiography and lung ultrasonography examinations in diagnosis of the newborn hyaline membrane disease (HMD). Methods The X-ray and ultrasonic diagnosis of the lung of the 78 neonates that were suspected to the HMD were carried and then the results were analyzed. Meanwhile, the detection rate of the complications was analyzed by using the statistics. Results The results of the X ray showed that 15 HMD was the first level, 39 HMD was the second level, 18 HMD was the third level and 6 HMD was the fourth level. The results of the lung ultrasonic diagnosis showed that the lung consolidation and air bronchogram could be seen in the lung ultrasonography. The A line abolition, pleural abnormalities, pneumonedema and alveolus-mesenchymal syndromes were found in the 56 HMD. The pulmonary smooth disappearance and lung beat were found in the 24 HMD. The lung beat were not found in the 3 Second level HMD. The different level pleural effusion was found in the 5 HMD. The complications detection rate of the hyperacoustic group was higher than the X-ray group and the results were statistical significance (P<0.05). Conclusion The lung ultrasonography is a new way for the diagnosis of the HMD. It is featured with the advantages of usefulness, convenience, non-invasion and repeatability in examinations. The detection rate of the complications with the ultrasonography surpasses the X-ray.