Although there have been several advancements in the diagnosis of neonatal sepsis, it still remains a major challenge, as there is no specific and sensitive marker for the timely diagnosis. Frequent incidence of noninfectious conditions that resemble to the clinical picture of neonatal sepsis, primarily in very low birth weight preterm infants, that complicates the identification of neonatal sepsis.The present study was undertaken to assess the significance of the hematological scoring system (HSS) for early detection of neonatal sepsis in total 42 cases with blood culture proven neonatal sepsis of 102 clinically diagnosed neonates admitted to the Neonatal Intensive Care Units (NICU) in El Menoufia and El Kalyoubia governorates hospitals versus 30 age matched healthy controls. The following HSS parameters were found to be significant for the early diagnosis of neonatal sepsis; Total WBC count, Total PMN count, Immature PMN count,  I:T PMN ratio and Platelet count while the most sensitive parameters was degenerative changes and toxic granulation in PMNL.