Abstract: Objective To explore the value of arterial lactate level and early lactate clearance in the severity and prognosis of neonatal asphyxia. Methods A total of 134 neonatal asphyxia patients enrolled in our department from August 2017 to August 2018 were selected as study subjects, and arterial blood lactate levels at the initial admission and 6 h after treatment were recorded. Two times of grouping and data comparison analysis were performed: ①Apgar score 1 minute after delivery of neonates was divided into groups: 0-3 for severe asphyxia group and 4-7 for mild asphyxia group. To compare the initial level of arterial blood lactic acid between the two groups and the level of arterial blood lactic acid after 6 h of treatment, and to compare and analyze the differences.②According to the 6 h arterial blood lactic acid clearance rate, it was divided into the high lactic acid clearance rate group (lactic acid clearance rate is more than 10%) and the low lactic acid clearance rate group (lactic acid clearance rate < 10%). To observe the poor prognosis of the two groups of children with multiple organ injuries during subsequent treatment and analyze and evaluate the value of early lactate clearance rate in the severity judgment and prognosis evaluation of neonatal asphyxia. Results There were statistically significant differences between the two groups in the initial concentration of arterial blood lactic acid and the concentration after 6h of treatment (all P<0.05). In the lactate high clearance group, multiple organ injuries occurred in 26 cases, but did not occur in 65 cases, with an incidence rate of 28.6%. Furthermore, 29 cases of multiple organ injuries occur in the low lactic acid clearance rate group, while 14 cases didn't occur (67.4%). The chi-square test showed statistical significance (χ²=18.233，P<0.001). Conclusions The level of arterial blood lactic acid in asphyxiated neonates is correlated with the degree of asphyxiation. The higher the level of lactic acid in arterial blood, the more severe the degree of asphyxiation of neonates. The early (6 h) lactate clearance rate is of great significance in the prognosis evaluation of neonatal asphyxia with multiple organ damage. The higher the lactate clearance rate in the early stage (6 h), the lower the possibility of multiple organ damage.