Neonatal mortality is considered as a sensitive and reliable measure of perinatal health delivery. Accurate data concerning current neonatal mortality and morbidity rates are of crucial importance to obstetric and neonatal management, for counseling parents, and for health care planning. The present study was undertaken to determine the neonatal morbidity and mortality at intensive care units in Alexandria in addition to studying the factors affecting the newborn mortality. Data were collected retrospectively through the record linkage of maternity data and neonatal data in the intensive care units of El - Shatby and Gamal Abd - El - Naser hospitals. Every other record of infants admitted to the neonatal intensive care in the year 1998 was selected by systematic random procedure. The total number of records reviewed were 1280. Results of the present study indicated that, about 60.6% of infants were preterm, 59.1% were of low birth weight [LBW]. The overall neonatal mortality was 578.1 per 1000 neonates. There is a significant linear trend relating the increasing birth weight and gestational age to decreasing likelihood of neonatal mortality. There were no survivors below 28 weeks of gestation. Within each gestational age the increase in median birth weight reduce the risk of neonatal deaths. Neonatal mortality for preterm infants was 69.1% as compared to 40.5 % for full term neonates. The highest percentage of neonatal deaths were among those of very low birth weight [89.9%], followed by 60.3 % & 38.5% for those of low and normal birth weight respectively. Respiratory distress syndrome [RDS] was the cause of death of about 37% of neonates being higher among preterm as compared to term infants [51.5 % versus 13.9% respectively]. Stepwise logistic regression delineated that low birth weight infants and those of preterm delivery were the first two predictors for mortality [OR =2.54, 1.81] relative to those with normal weight and term infants respectively, the other predictors were respiratory distress syndrome [RDS], apnea, asphyxia, sepsis, intracranial hemorrhage, congenital anomalies and pneumonia. Greatest emphasis should be given on antenatal care which will prevent preterm and low birth of babies. Improving of intensive care for progressively smaller infants, and to be musi carefully monitored by every perinatal center. Pediatricians must be knowledgeable regarding urge the improved outcome for such infants so they can effectively urge an optimistic and seemingly aggressive approach.