Background: Birth before the 37^th week (259^th day) of pregnancy, measured from the first day of the last menstrual cycle, is referred to as preterm. Objective: Early prediction of neonatal outcome in preterm neonate. Patients and Methods: This was a prospective cohort study carried out in Neonatal Intensive Care Unit in Zagazig University Children Hospitals for 6 months. The estimated sample was 58 neonates. Results: About65.5% died and 34.5% were discharged alive. There was statistically significant relation between outcome and maternal age. Singleton pregnancy represented 92.1% and 95% of those died and discharged respectively. There was statistically significant relation between outcome and order in family. Mortality was significantly higher among those with first order (42.1% and 15% within who died and discharged respectively). There was statistically significant relation between outcome and Apgar score at 1 minute, at 5 minutes and at 10 minutes. The best cutoff of Apgar at 1 minute in prediction of mortality was ≤6.5 with area under curve 0.961, sensitivity 92.1%, and specificity 90%. The best cutoff of Apgar at 5 minutes in prediction of mortality was ≤7.5 with area under curve 0.944, sensitivity 84.2%, and specificity 95%. The best cutoff of Apgar at 10 minutes in prediction of mortality was ≤8.5 with area under curve 0.914, with sensitivity 84.2%, and specificity 90%. Conclusion: Premature infants with a low Apgar score have a higher mortality rate.