The rationale for the use of the drug L-carnitine (Levocarnitine) in the complex treatment of neonatal pneumonia was metabolic disorders and carnitine deficiency in premature infants with perinatal pathology. The aim of the study was to increase the effectiveness of treatment of premature newborn infants with respiratory distress syndrome complicated by "ventilator-associated" pneumonia on the basis of correction of carnitine deficiency. We examined 80 premature infants with this pathology. All infants received basic therapy (antibiotics, intravenous immunoglobulin, oxygen therapy, infusion therapy, parenteral and enteral nutrition, oxygen therapy, treatment of anemia). 40 infants received an additional drug L-carnitine at a dose of 100 mg/kg per day enteral for 25 days. The daily dose was divided into two administrations. 40 infants did not receive L-carnitine and were on basic therapy. The use of L-carnitine in the complex treatment of RDS complicated by VAP had a positive therapeutic effect. We noted an increase in the rate of baby body weight, a reduction in the time of relief of clinical symptoms of the disease, the duration of oxygen therapy, antibiotic therapy, hospital stay in comparison with infants who did not receive this drug.