Background: Key performance indicators (KPIs) indicate, define and measure performance progress, and focus on a range of areas. A healthcare KPI is a well-defined performance measurement that is used to monitor, analyze and optimize all relevant healthcare processes for best patient care.  Aim of the Work: The study aimed to measure selected key performance indicators (KPIs) for neonatal intensive care units (NICUs) in two tertiary care hospitals and assess the feasibility and acceptability among experts in NICU care. Patients and Methods: A retrospective medical record review for 6-months of 400 neonate patients' regarding 10 essential KPIs in NICU care at Ain Shams University and Al Mataria Teaching Hospitals, as well as surveys with expert staff of both hospitals.  Comparing the statistics for both hospitals, demographic study revealed that both hospitals had a slightly higher percentage of male patients, however, gestational age distribution reveals a mean gestational age of 36.2 weeks and 2.6 kg for weight, indicating a near-term population. In contrast, Ain Shams showed a higher incidence of chronic lung illness (47.6%) and late-onset sepsis (34%), while Al Mataria had a larger percentage of neonates discharged breast-fed (79.5%). Staff attitudes on KPIs varied across the two institutions, with a strong emphasis on KPI implementation in the areas of chronic lung illness, necrotizing entero-colitis (NEC), discharge breast fed, and hypoxic ischemic encephalopathy. Retinopathies of prematurity and prolonged hospitalization are evaluated as neutral to low. Management levels had the greatest impact on late-onset sepsis (LOS) and NEC. Professional practices had the greatest influence on chronic lung illness and IVH. The outcome indicates a 40.8% acceptance rate, indicating that hospital staffs in the NICU are satisfied for KPI tracking. Conclusion: The study reveals significant differences in KPIs prevalence, perceived barriers, responses, and impact on patient outcomes. Key indicators like late-onset sepsis and chronic lung disease have significant impacts, while others like retinopathy of prematurity have divergent perceptions. Regular tracking of KPIs in NICUs can improve clinical practices, reduce morbidity and complications, and enhance communication and collaboration. This comprehensive analysis enables NICUs to provide high-quality care to vulnerable patients, improving outcomes and reducing morbidity.