Congenital cystic adenomatoid malformation (CCAM) is a rare bronchopulmonary tissue proliferation disease. Al- though CCAM type I (CCAM I) has a good prognosis, respiratory distress and sepsis comorbid can worsen surgical outcomes. This case aims to explain the intensive care of a newborn with respiratory distress and sepsis before lobec- tomy. In this case, a female newborn with severe respiratory distress due to CCAM I faced two dilemmas of sepsis co- morbid and early lobectomy consideration. We decided to increase the sensitive antibiotics dose of Ampicillin-Sul- bactam to 100 mg/kg/12hours (standard dose: 50 mg/kg/12hours) and Amoxicillin to 90 mg/kg/day (standard dose: 45 mg/kg/12hours). This decision successfully showed negative blood culture before surgical consideration. A left inferior lobe lobectomy was then performed, despite the newborn respiratory function had not been well improved. Eight days after lobectomy, the left lung developed well without any complications. Hence, immediate lobectomy is recommended to restore lung function and prevent recurrent infections and pneumothorax.