Objective To explore the occurrence of tip malposition of peripherally inserted central catheters（PICCs） and the possibility of spontaneous correction among neonates. Methods Incidence of PICC tip malposition in neonates with upper and lower limb catheterization from June 2015 to May 2018 was retrospectively reviewed and compared. The rate of spontaneous correction of tip malposition via different veins was calculated and reasons were analyzed. Results A total of 425 cases of neonatal PICC catheterization，and 72 cases had tip malposition，of which 22 cases were spontaneously corrected to the optimal position of superior and inferior vena cava within 48 h. The rate of malposition via upper limb was significantly higher than that via lower limb（P<0.01），however，the spontaneous correction rate via upper limb was also significantly higher than lower limb（P<0.01），especially the rate via internal jugular vein was as high as 71.4%. Conclusion Part of tip malposition of PICCs can be spontaneous corrected. PICCs with tip malposition identified by initial X-ray were not recommended for withdrawal or removal，which can be used as a peripheral vein. Imaging?guided catheter tracking within 24h after catheterization can be performed to determine spontaneous correction. PICCs without spontaneous correction can be re-catheterized，or used as peripheral venous catheter.