Background: Neonatal sepsis is a major cause of morbidity and mortality in newborns, especially in developing countries. Early detection and identification of mortality risk factors are critical for improving outcomes.

Aim: To study the incidence, causative organisms, and mortality-associated risk factors in neonatal sepsis.

Materials & Methods: A prospective observational study was conducted on 200 neonates admitted with suspected sepsis. Blood culture was performed, and demographic & clinical data were analyzed. Factors such as birth weight, gestational age, maternal risk, mode of delivery, and laboratory parameters were correlated with mortality.

Results: Incidence of confirmed sepsis was 32%. Mortality rate was 28% among sepsis-positive neonates. Low birth weight (<2.5 kg), preterm birth (<37 weeks), prolonged rupture of membranes, need for ventilatory support, and high CRP (>10 mg/L) were significantly associated with death.

Conclusion: Neonatal sepsis remains a major cause of neonatal mortality. Early diagnosis, infection control, and timely antibiotic therapy can significantly reduce deaths.