B/O kavita male baby was delivered prematurely at 27 weeks of gestation by emergency caesarean section in view of severe PIH n absent diastolic flow with birth weight of 750 grams. After birth baby bad poor respiratory efforts. Bag and mask ventilation was done and baby was electively intubated i/v/o poor respiratory efforts. Baby was shifted to NICU, connected to mechanical ventilation and surfactant was given twice i/v/o hyaline membrane disease. Baby was loaded with caffirate i/v/o Prematurity. On day 3 of life, baby had decreased platelet counts s/o Sepsis. Antibiotics were upgraded. On day 4 of life baby had abdominal distension and greenish aspirates from Ryles tube, xray abdominal was done s/o gut perforation. Emergency exploratory laparotomy was performed and perforation was seen at ileum for which ileostomy was done. During the hospital stay baby also requires multiple transfusions. Presently baby is with ileostomy opening with stoma bag in situ. Baby has been extubated and still on CPAP. Baby will be requiring NICU for longer than 2 months.