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Background: Neonatal mortality remains a major contributor to death among children younger than 5 years in developing countries. It accounts for approximately 40% of all childhood mortality in resource-poor countries. Each year, 7 million neonates globally are stillborn or dying within 30 days of birth (neonatal period). Reducing Neonatal mortality requires that interventions be readily accessible and available in the immediate perinatal period. Such countries have weak health metrics and systems, resulting in a paucity of perinatal and neonatal mortality information and a deficiency in quality of available data. Objective: This study was undertaken to determine the neonatal mortality rate (NMR) and perinatal mortality rate (PMR), causes of death, and associated risk factors among hospital live births admitted to the NICU of Misurata teaching hospital in Libya. Methods: A descriptive, retrospective study based on hospital files records. From January 2013 to December 2013, information was collected from the registration book at labour room including operating theatre and newborn admitted in the neonatal intensive care unit of Misurata teaching hospital in Libya. The information collected include, history, clinical examination, investigation, treatment and outcome.