Introduction: Tuberculosis (TB) a preventable disease caused by Mycobacterium tuberculosis, world’s leading cause of death from a single infection, while 45% of new cases occurring in the South-East Asia. To prevent TB routine Bacille Calmette- Guérin (BCG) vaccine is given to all newborns. Objectives and Methods: To calculate the rates of adherence to the guideline in neonates bornin DGH Nawalapitiya over three months duration. Results: Among 149, mean gestational age 37 .46 (SD +/- 3.45). weeks of POA. Mean birth weight2728.4 g (SD = 422.5 g). Majority were term (>37 weeks, 83.9%). 134 (89.33%) received BCG within 24 hours of birth, 16 (10.67%) did not, of them 15 (93.75%) were vaccinated before discharge, one (6.25%) did not, as he received IVIG. BCG one each day 3, 10,24, Two each on day 2,5,9, three on day 6, four on day 8. BCG coverage was slightly higher among term infants (91.2%). Of the 40 infants weighing 1.5–2.5 kg, 87 .5% received BCG before discharge, while among those weighing >2.5 kg, 90.0% vaccinatedThere was no association of delay related to birth weight or POA . Reason for delay in majority (15) were, antibiotic treatment (80%), while 3 (20%) were not. Most common combinations were Gentamycin with C Penicillin (58.33%) and C Penicillin with Cefotaxime 33.33%) and Meropenem (8.33%). Conclusion: This indicates that although a small proportion of babies experienced delayedvaccination beyond 24 hours, nearly all of them were subsequently immunized before leaving the hospital indicating 100% adherence to current guideline.