Abstract： Objective To study the effect of peripheral arteriovenous synchronous simultaneous exchange transfusion on neonatal hyperbilirubinemia. Metheds 25 patients were selected and treated by transfusion to peripheral venous( great or small saphenous vein, vein on back of hand or dorsum of foot), while drawing blood from peripheral artery(radial artery or brachial artery). Synchronous exchange transfusion speed was 10- 20 ml per 5 minutes, and the prepared blood was twice as much as the children's total blood volume ( 150～180 ml/kg). The total serum bilirubin, indirect bilirubin, direct bilirubin, electrolyte and blood routine were detected before and after exchange transfusion. Results The concentration of three kinds of bilirubin reduced significantly(P<0.01 ). The exchange rates of total serum bilirubin, indirect bilirubin, direct bilirubin were 52.6％, 53.2％ and 38.0％ after exchange transfusion,respectively. Hemoglobin was increased( P<0.01 ),while leucocyte (P<0.01) and platelet (P<0.05 ) decreased in normal range. No significant changes were found in blood potassium, sodium and calcium, while serum glucose was increased (P<0.01 )after exchange transfusion. Conclusion Peripheral arteriovenous synchronous simultaneous exchange transfusion treatment for servere neonate hyperbilirubinemia is a simple, effective way Application should be promoted.