Neonatal necrotizing enterocolitis (NEC), characterized by rapid onset, difficult early diagnosis, high mortality and many postoperative complications, is a common pediatric surgical acute abdomen. Current clinical debates mainly center around two issues: firstly, the surgical timing and procedure selection; secondly, how to preserve the length of small bowel as adequately as possible and prevent the occurrence of short bowel syndrome. The authors, in this paper, address the current research progress in surgical treatment of NEC, with the prospect of seeking enlightenment and solutions.