Introduction: Preterm infants face significant health challenges, particularly in the Neonatal Intensive Care Unit (NICU) environment, where sensory overload can stress their fragile physiological systems. Auditory interventions, such as maternal lullabies, have shown potential in improving physiological stability by mimicking in-utero sensory stimulation. Objective: This pilot study assessed the effects of maternal lullabies on respiratory rate, heart rate, and oxygen saturation in hemodynamically stable preterm, low birth weight neonates. Methods: Twenty neonates, born at 28-34 weeks' gestation and weighing 0.8-2.0 kg, were randomly assigned to an experimental group (maternal lullaby) or control group (routine care). Over three days, neonates were exposed to the maternal lullaby “Chanda Mama Dur Ke” for 20 minutes, and their physiological parameters were measured before, during, and after the intervention. Data were analyzed using descriptive statistics and statistical tests, including t-tests and ANOVA. Results: In the experimental group, the respiratory rate significantly decreased (p = 0.000) from 53.00 to 44.20 breaths per minute, heart rate reduced from 165.60 to 143.20 bpm (p = 0.000), and oxygen saturation increased from 90.00% to 95.40% (p = 0.000). The control group showed modest improvements, with less pronounced physiological changes. Conclusion: Maternal lullabies significantly improved respiratory rate, heart rate, and oxygen saturation in preterm neonates, suggesting that maternal auditory interventions could enhance neonatal care. Further research is recommended to explore the long-term benefits and broader applicability of this intervention in diverse neonatal populations.