【Abstract】 Objective To analyze the ultrasound screening results of urinary system in high-risk neonates and the guidance significance for neonatal prognosis. Methods A retrospective analysis was performed on ultrasound screening and follow-up treatment results of 106 high-risk neonates admitted to the hospital from January 2017 to October 2018. The ultrasound imaging findings related to urinary system abnormalities, ultrasound screening of urinary system abnormalities in high-risk neonates, high-risk factors in neonates with urinary system abnormalities, hydronephrosis sites and grading, renal pelvis separation and follow-up results of children with urinary system abnormalities were analyzed. Results Of 106 high-risk neonates, ultrasound screening found that there were 32 cases (30. 19%) with abnormal urinary system, including 26 cases (24. 53%) with hydronephrosis and 6 cases (5. 66%) with other developmental abnormalities. The high-risk factors for neonates with system abnormalities were mainly on low body weight, premature delivery, and gestational hypertension. Their positive rates were 31. 57 % , 19. 04% , and 12. 82% , respectively. It could be seen that high-risk factors might occur alone or simultaneously. There were 18 cases, 3 cases and 5 cases with left, right and bilateral hydronephrosis, respectively. There were 10 cases, 2 cases and 3 cases with left, right and bilateral mild hydronephrosis, respectively. There were 5 cases, 1 case and 1 case with left, right and bilateral moderate hydronephrosis, respectively. There were 3 cases, 0 case and 1 case with left, right and bilateral severe hydronephrosis, respectively. In the 31 hydronephrosis from hydronephrosis neonates, the number o£ hydronephrosis with renal pelvis separation degree less than 5mm, within 5-15mm and more than 15mm were 9 (29. 03%) , 18 (58. 06%) and 4 (12. 90%) , respectively. 32 u- rinary system abnormal high-risk newborns were followed up for 6 months to determine their prognosis, with follow-up rate of 100%. Among the 26 hydronephrosis children, there were 19 case hydronephrosis disappearing, and the remaining 7 cases were still accompanied with hydronephrosis. There were 2 cases with vesicoureteral reflux due to urinary tract infection. The kidney development o£ children with other abnormal urinary system children was gradually improved, or the conditions were improved after related treatment. Conclusion Ultrasound can be applied to screen urinary system abnormalities in high-risk neonates. The main abnormal type was hydronephrosis. Most o£ the urinary system abnormalities are effectively improved by late development or related treatment.