Introduction: Intestinal obstruction is one of the most common reasons for admission to a neonatal surgical unit. The incidence is approximately 1/1500 live births. Intestinal obstruction can be classified into five major types; congenital, strangulated, adhesive, adynamic and necrotizing enterocolitis. Aim of the Work: In our study, the aim was to highlight the most common causes of neonatal intestinal obstruction in Egypt, their relative incidence and importance of ante-natal and early post-natal diagnosis, and to suggest a protocol for the proper management of these babies, in order to improve the survival rates. Patients and Methods: This study was carried on 121 neonates suffering from intestinal obstruction. Patients included in the present study aged from 1 hour up to 28 days. All patients were subjected to careful clinical assessment as well as full investigations for assessment of the cause of intestinal obstruction. Operative management, as required, was started immediately after resuscitation usually within 2-6 hours and the outcome studied. Results: Ninety three patients were operated upon, while 28 patients were managed conservatively. Eighty six patients improved (71% of cases), while 35 patients died (29% of cases). The common causes of death were severe associated congenital anomalies, delayed presentation and surgical complication. Conclusion: Survival rates of neonatal intestinal obstruction in our hospital have improved. This was achieved by meticulous preoperative resuscitation, precise surgery which is important to reduce complications and increasing the facilities of NICSU.