Background: The congenital anomalies that indicate colostomies in neonates at any tertiary paediatric surgery centre are Hirschsprung's disease, anorectal anomalies, and colonic atresia and they constitute the main bulk of colostomy workloads. Objective: In this study, we aimed to evaluate the indications, site of creation, type of colostomy, and complications of colostomy in new-born in the last three years in a single tertiary center. Patients and Methods: This study was a retrospective cohort study that was carried out in the Paediatric Surgery Department, Tanta University Hospital, Egypt to evaluate the indications, site of creation, types of colostomies, and complications of colostomy in new-born over three years from March 2018 to March 2021. Results: High anorectal malformations (90%) and Hirschsprung's disease (5%) were the most common causes of creation of neonatal colostomy. Out of 120 neonates, 71 (59 %) patients were males, and 49 (41 %) patients were females. The gestational age ranged between 35 and 40 weeks with a mean of 37.55 ± 1.43 weeks (mean ± SD). Complications of colostomy were seen in 38 (31.6%) neonates. Most common complications were skin excoriation in 22 (18 %) patients, stomal prolapse in 5 (4%) patients, bleeding from stoma site in 4 (3%) cases, wound infection in 3 (2.5%) cases, parastomal hernia in 2 (1.6%) patients, and dehiscence and stomal stenosis in one (0.8%) patient for each. Conclusions: Expert paediatric surgeons should perform or assist in colostomy creation operations in neonates and should pay close attention to proper choice of the site of colostomy with early management of complications and early closure of the colostomy.