Abstract Blind nasojejunal tube (NJT) insertion with radiographic confirmation often results in initial malposition and repeated imaging in neonates, raising concerns about procedural delays and cumulative radiation. Point-of-care ultrasound (POCUS) enables real-time, radiation-free guidance, but multicenter neonatal evidence has been limited. We conducted a multicenter, real-world retrospective cohort study across three tertiary NICUs in China (May 2023–May 2025).