Objective To evaluate the role of perfusion index（PI）in predicting the demands in neonates with septic shockfor vasoactive drugs during early recovery. Methods A total of 56 term infants with neonatal septic shock hospitalized in the neonatal intensive care unit（NICU）of Xinxiang Center Hospital from January 2018 to June 2020 were divided into vasoactive drug group（n = 31）and non⁃vasoactive drug group（n = 25）according to the need to use vasoactive drugs. Results （1）The cut ⁃ off value of PI in predicting the neonates′ vasoactive demands was 0.28，the sensitivity andthe specificity were 90.3% and 96%，respectively and the AUC was 0.96（95% CI：0.91 ~ 1.00；P < 0.001）.（2）The cut⁃off value of the arterial lactate level in predicting their vasoactive demands was 5.45 mg/dL，the sensitivity and specificity were 74.2% and 92%，respectively and the AUC was 0.89（95% CI：0.81 ~ 0.97；P < 0.001）.（3）Other perfusion variables failed to predict their vasoactive demands in the septic shock infants. Conclusion PI and arterial lactate levels can predict the demands in septic shock infants for vasoactive drugs.