In Kabupaten Pekalongan, in 2015 23.7% of infant mortality is due to asphyxia. Results of preliminary studies that have been conducted from 14 midwives in the Maternity Room, 11 midwives with less obedient category, 3 midwives with enough obedient category. The purpose of this study is To identify Factor Factors Associated with Compliance Implementation of Operational Standard Asphyxia Handling Procedures in RSUD Kraton District Pekalongan. This study was conducted from April 24, 2017 to June 30, 2017.The type of research used in this study was observational, using cross sectional approach. The population in this study were all the midwives directly involved in the treatment of asphyxia in newborns a total of 34 people. Sampling technique used in this study is Total Sampling amounted to 34 people. The research instrument using questionnaires that have been tested the validity with the results for the number N = 20 and significance 0.05 t table value is 0.444 said valid and reliability using Alfa Cronbach obtained alpha value 0.976 larger than r table is said reliable, as well as checklist SOP handling AsphyxiaData analysis using statistics through chi square test. The results of this study indicate that there is a relationship between training with compliance implementation Standard operational procedures Asphyxia handling with value p = 0.002 smaller than 0.05. There is a relationship between the level of knowledge with compliance implementation Standard operational procedures Asphyxia handling with value p = 0.002 smaller than 0.05.It is hoped that the results of this study adds information to midwives that training and knowledge are essential to improve a midwife's ability to perform management in asphyxia infants.