OBJECTIVE: Accurate assessment of neonatal outcomes referred to the neonatal intensive care unit is still lacking. The objective of this study is to analyze the morbidity and mortality of referral neonates.
METHODS: This was a descriptive analysis study undertaken at a tertiary referral hospital in a year. All referral neonates admitted to the intensive care unit were included in the study. 
RESULTS: In 2018, A total of 202 referral neonates were admitted, out of which 8 were excluded from the study. AS a result, 194 neonates were included for analysis with 55.67% male and 44.33% female, giving a male to female ratio 1.2: 1. Term infants appropriate for gestational age 61.86%, and preterm infants appropriate for gestational age 37.11%. The leading cause of admission was sepsis (79.90%), neonatal pneumonia (64.43%), hyaline membrane disease (24.74%), and others such as apnea of prematurity, congenital heart disease, hypoxic ischemic encephalopathy, and meconium aspiration syndrome. The neonatal mortality rate was 37.11% and more than two-thirds deaths were within first week of life, with no sex predilection. The most common causes of mortality were sepsis (76.39%), followed by neonatal pneumonia (59.72%) and membrane hyaline disease (27.78%). 
CONCLUSION: Neonatal mortality was 37.11% in our study. Sepsis and neonatal pneumonia were the leading causes of admission in our study. The preventable causes should be urgently addressed to achieve the Millennium Development Goals.