Kernicterus is a preventable brain injury resulting from severe untreated neonatal hyperbilirubinemia. The aim of the current study was to evaluate the risk factors and neurological outcome of cases of severe hyperbilirubinemia. In this prospective study, 117 newborns with severe hyperbilirubinemia (≥20 mg/dl) or necessitating blood exchange according to AAP were admitted to NICU of CUPH during a period of 3 months (May, June and July 2012). The mean gestational age was 37.8±0.6 weeks, the mean age of onset of jaundice was 2.91±1.35 days. The mean level of total bilirubin was 26.15±6 mg /dl. At a chosen cut off value of B/A ratio of 9.6 sensitivity was 100% while specificity was 91.4%. During the follow up period at the age of 3 months, there were 7 infants recorded to have signs suggestive of kernicterus. They represented (6.2%) of the total number of infants. The mean level of total bilirubin was 38.8±4.5 mg /dl and the mean bilirubin albumin ratio was 11.7±1. 49. From the current study, we concluded that kernicterus is still a major problem in our community. Screening of all newborns before discharge from the maternity unit will help to prevent this problem. Long term follow up of these cases is required to detect long term sequelae.