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Objective To investigate the diagnosis and treatment data of neonates with necrotizing enterocolitis (NEC) undergoing surgical treatment in our hospital, and to provide a reference for the selection of optimal surgical timing and approach in clinical practice. Methods A retrospective analysis was performed for the clinical data of 84 neonates with NEC who were admitted to our hospital from January 2015 to December 2020, and all neonates underwent plain abdominal radiography. During the surgery, enterostomy or resection of the necrotic intestinal canal followed by intestinal anastomosis was performed according to the location and extent of necrotic intestinal canal. The neonates were followed up to observe the changes in diet, defecation, and body weight, and their surgical outcome was summarized. Results Among the 84 neonates, 2 underwent intestinal decompression and peritoneal drainage; 72 underwent enterostomy, among whom 67 underwent ileostomy and 5 underwent distal jejunostomy; 7 underwent resection of the necrotic intestinal canal followed by intestinal anastomosis; 3 were withdrawn from treatment. Of all neonates, 77 had good prognosis; 2 had poor prognosis and required regular parenteral nutrition support due to short bowel syndrome; 2 died of necrotic enteritis at 6 months after surgery; 3 were withdrawn from treatment due to extensive bowel necrosis observed during surgery. Conclusion Neonates with NEC tend to have a high mortality rate, and enterostomy is the main treatment method at present. Timely surgical treatment has a good therapeutic effect on children with NEC.