Abstract: Near-infrared spectroscopy (NIRS) can directly measure the oxygenation of organs and tissues and is superior to percutaneous oxygen saturation monitoring technology, which only reflects the oxygen partial pressure in blood and oxygen saturation in acral arterioles. This review summarizes the feasibility, safety, and effectiveness of NIRS in identifying fetal conditions by monitoring placental oxygenation, evaluating adverse pregnancy outcomes caused by hypoxia during the fetus-to-neonate transition, providing precise guidance on resuscitation, and optimizing early postnatal respiratory and circulatory support.