Objective To compare the efficacy of domestic and imported caffeine citrate in the treatment of apnea in preterm infants. Methods A total of 98 preterm infants with a gestational age of 28- < 34 weeks between April 2018 and December 2019 were enrolled. They were randomly administered with domestic (n=48) or imported caffeine citrate (n=50) within 6 hours after birth. The therapeutic effects, complications, adverse effects and clinical outcomes were compared between the two groups. Results There were no significant differences in the incidence of apnea within 7 days after birth, daily frequency of apnea, the time of apnea disappearance, the failure rate of intubation-surfactant-extubation strategy, the time of non-invasive assisted ventilation, the duration of oxygen therapy, the duration of caffeine citrate therapy, the length of hospital stay, blood gas analysis results, liver and kidney function testing results between the two groups (P > 0.05). There were no significant differences in the incidence of complications and the mortality rate between the two groups (P > 0.05). There was no significant difference in the incidence of adverse effects between the two groups (P > 0.05). Conclusions The efficacy and safety of domestic caffeine citrate in the treatment of apnea are similar to those of imported caffeine citrate in preterm infants.