Objective: This research was conducted with a medical records-based, retrospective design to examine the predictive value of umbilical cord lactate measurement as an early indicator of well-being and severe conditions in term neonates. Materials and Methods: The study sample consisted of 81 term neonates with a gestational age of ≥37 weeks who experienced respiratory distress and were treated and monitored in the neonatal intensive care unit, and who had a cord arterial blood gas measurement performed at birth. The data were retrospectively collected from hospital records. Results: The umbilical cord arterial lactate value was associated with the pH level and analysis revealed that it predicted a low Apgar score, commonly used as a wellness assessment of a neonate (p<0.05). The lactate value was significantly high at birth in neonates with meconium aspiration syndrome and premature rupture of membranes in comparison with the pH and other cord gas parameters, suggesting that it may be an early predictor of distress. Receiver operating characteristic curve analysis determined that the lactate value was a more sensitive measurement than pH in predicting a low first-minute Apgar score. It was also found that as the lactate level increased, the length of hospitalization increased. Conclusion: The results suggested that cord lactate is at least as predictive as the Apgar score and the pH level as an early means to determine severe conditions in neonates. Lactate might be a useful variable for clinicians at first-level hospitals to consider in their decision to refer a patient to a secondary or tertiary neonatal intensive care unit before the clinical situation deteriorates.