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OBJECTIVE: To assess the effects of prophylactic antenatal dexamethasone administration in reducing the neonatal respiratory morbidity at term after elective lower segment caesarean section (LSCS). METHODS: This open label randomized-controlled trial was conducted in Department of Obstetrics and Gynaecology, Kahuta Research Laboratories (KRL) Hospital, Islamabad from September 2017 to February 2018. Patients with singleton pregnancy and non-anomalous fetus between gestational age of 37+0 and 38+6, planned to be delivered by elective LSCS were randomized through block-randomization method into interventional group (A): who received dexamethasone and control group (B): who did not receive prophylactic dexamethasone. Main outcomes of the study included Apgar-score at one & five minutes, admission to neonatal intensive care unit (NICU) due to transient tachypnea of newborn (TTN) and respiratory distress syndrome (RDS). Data was analyzed by SPSS version 23. RESULTS: A total of 304 women were randomized and equally assigned to interventional and control group. In group-A, 2 neonates developed RDS as compared to one neonate in group-B (p=0.391). Mean age of patients in group A and B was 30.48±4.18 years and 29.38±4.57years respectively. Five-minutes Apgar score was 8.91±0.290 in group A & 8.87±0.393 in group B (p=0.320). TTN developed in four neonates in group-A while one neonate in group-B (p=0.176). Eighteen (11.8%) cases in group A & 12(7.9%) cases in group B were admitted in NICU (p=0.249). CONCLUSION: Prophylactic dexamethasone administration in term LSCS after 37 weeks of gestational age has no significant effects on reducing the incidence of RDS, TTN and neonatal admission to NICU.