Background: Congenital disorders are common conditions. The incidence of malformations in the neonate variations both between countries and between regions within the same nation. Objective: The aim of the current work was to determine the spot incidence of congenital malformations among neonates at Obstetric Department of El-Ahrar Zagazig Hospital. Patients and methods: This prospective descriptive study included a total of 31 babies who were noted to have congenital malformation, attending with their parents at the Obstetric Department and the Neonatal Intensive Care Unit (NICU), El-Ahrar Zagazig Hospital. The total number of deliveries during the period of the study was 1254. Results: Congenital anomalies incidence was 2.47%. The greatest incidence of congenital abnormalities (CAs) involved the musculoskeletal system, abdominal wall and skin (in 23%), the central nervous system (in 19%), the cardiovascular system (in 19%), the genitourinary system (in 13%), the gastrointestinal tract (in 10%), the orofacial (in 10%) and chromosomal aberrations (in 6.5%). Most cases of congenital anomalies were full term. Conclusion: It could be concluded that the spot incidence of congenital anomalies among liveborn neonates in Zagazig locality accounts for 2.5% (31/1254 deliveries).