Background: Early and late onset sepsis is defined as presenting before and after the first 72 hours of birth. The general fatality rate of early-onset sepsis varies between 15-40%. Objective: The aim of study is to detect outcome of neonatal sepsis in Neonatal Intensive Care Unit. Patients and methods: This study consisted of 190 neonates at Neonatal Intensive Care Unit in Zagazig University Hospitals with (69.5%) of them were admitted to NICU in the 1^st day, (27.9%) with gestational age more than 37 weeks, (40.0%) had weight from 1500- 2000 gram, males represented (52.2%) and (55.3%) were born by cesarean section. They were divided into 2 groups; positive and negative blood culture groups. Results: Pregnancy age and birth weight were statistically significantly different between the groups, the septic and non-septic groups differed statistically in all manipulations except IV cannula. There was statistically significant difference between the septic and non-septic groups as premature labor, obstructed labor, mother RH -ve or +ve, premature rupture of membranes (PROM), chorioamnionitis, antepartum hemorrhage, respiratory distress, prematurity, CNS insult and perinatal asphyxia and congenital anomalies, ventilation modes, ventilation duration, hospital stay and causes of death. Conclusion: Prematurity, low body weight (BW), obstructed labor, PROM, chorioamnionitis, umbilical catheterization and mechanical ventilation are the most important risk factors. The commonest cause of admission to NICU was respiratory distress followed by prematurity and lastly hypoglycemia. Klebsiella pneumonia, Staphylococcus aureus and E-coli are the most common isolated organisms of blood cultures.