Abstract: Objective To explore the effect of early warning and graded management on hospital transit time and adverse events of critical premature infants, so as to improve the clinical outcomes of patients. Methods A total of 40 critical premature infants from March to June, 2019 were selected as control group and 40 critical premature infants from July to October, 2019 as observation group. The control group was transported by conventional transfer method, while the observation group was transported by early warning and grading management method on the basis of the conventional transport method. The transit time, incidence of adverse events and incidence of adverse outcomes were recorded and compared between the two groups. Results The transit time of the observation group was(12.29±2.14) min, which was evidently lower in comparison with the control group(18.65±3.37) min(P<0.05). The occurrence rate of adverse events was 2.50%(1 case of tracheal intubation disconnection) in the observation group, which was obviously reduced in contrast to the control group(20.00%; 2 cases of tracheal intubation disconnection, 2 cases of venous catheter blockage, 1 case of oxygen deficiency, 2 cases of monitor lead disconnection, and 1 case of instrument failure), P<0.05. The occurrence rate of poor outcomes was 7.50%(1 case of abnormal breathing, 1 case of hypothermia and 1 case of hypoxia) in the observation group, which was visibly lower than the control group(47.50%; 4 cases of abnormal breathing, 4 cases of abnormal heart rate, 5 cases of hypothermia and 6 cases of hypoxia), P<0.05. Conclusion Early warning and graded management has a good effect on in-hospital transport of critically ill premature infants, which can not only effectively shorten transit time, reduce the incidence of adverse events, but also improve the outcomes of premature infants.