Meconium aspiration syndrome (MAS) is one of the most common conditions associated with aspiration during the newborn period. MAS can be defined as respiratory distress in a neonate born through meconium-stained amniotic fluid (MSAE) with symptoms that cannot otherwise be explained. It can be characterized by early onset of respiratory distress in term and near-term infants delivered through MSAE. Early presentation includes respiratory symptoms such as respiratory distress, poor lung compliance, hypoxemia, and radiographic findings of hyperinflation and patchy opacifications. This article discusses the pathophysiologv of MAS, historical and current prevention strategies, current management strategies, and prognoses for infants born through MSAE.