Background: Respiratory disorders remain a major cause of morbidity and prolonged hospitalization among neonates, particularly those admitted to neonatal intensive care units (NICUs). Chest physiotherapy (CPT) has traditionally been used as an adjunctive intervention to facilitate airway clearance and improve respiratory mechanics in this vulnerable population; however, its indications, techniques, and safety remain debated.

Objective: To narratively review the available evidence over the last decade regarding chest physiotherapy techniques used in neonates with respiratory disorders, focusing on clinical effectiveness, safety, and physiotherapy-specific implications.

Methodology: A narrative review was conducted using electronic databases including PubMed, Scopus, PEDro, and the Cochrane Library. Articles published between January 2014 and December 2024 were screened. Studies involving neonates (0–28 days) with respiratory disorders receiving any form of chest physiotherapy were included. Both randomized and non-randomized studies were considered. Data were synthesized thematically.

Results: Evidence suggests that selected chest physiotherapy techniques, particularly positioning, gentle vibration, and assisted airway clearance, may improve secretion clearance and short-term respiratory parameters in neonates with conditions such as respiratory distress syndrome (RDS), meconium aspiration syndrome (MAS), pneumonia, and post-extubation atelectasis. However, aggressive techniques such as percussion have limited support and potential risks.