Background: Blood transfusions is frequently life saving procedure in high risk neonate, but it is not without risks. The best transfusion practice in neonate provide good therapeutic outcome. Aim of this study was to assess nurses' performance regarding blood transfusion for neonates in Neonatal Intensive Care Unit. Research design: A descriptive design. Setting: Neonatal intensive care unit at Wady El-Natron Hospital and Etay El-Barod Hospital. Subject: A convenient sample include 60 nurses  working at the previous mentioned settings. Tools of the study involved; First tool: A structured Questionnaire sheet to assess nurses' knowledge about blood transfusion for neonates. Second tool: Observational checklists to assess the studied nurses' practices regarding neonatal blood transfusion. Third tool: Attitudinal  likert type scale to assess level of nurses' attitude regarding blood transfusion in neonates. Results: the results of this study showed that, half of the studied nurses  their ages ranged from 20 to<25 years and most of them were female.  While half of the studied nurses had years of experience <5 years and three quarters of them had graduated from health technical institute. Almost majority of the studied nurses didn't attend program related to blood transfusion. Also, there was positive correlation between total  level of knowledge, total level of practice and total level of attitude of the studied nurses. Conclusion: More than half  of the studied nurses had poor level of knowledge, near to two thirds of the studied nurses had incompetent level of practice and more than one third of the studied nurses had negative attitude regarding blood transfusion in neonates. Recommendations: Implementation of in service training programs for continuous updating nurses' knowledge regarding blood transfusion for neonates.