Background: Total parenteral nutrition (TPN) is the feeding of special nutritional products to the neonates intravenously, to bypassing the usual process of eating and digestion. Objectives: The aim of this study was to determine the outcomes of neonates on total parenteral nutrition prepared on ward (retrograde) or through laminar flow in Neonatal Intensive Care Units of Zagazig University Children’s Hospital. Patients and Methods: this retro and prospective cohort study was conducted on 420 neonates in Neonatal Intensive Care Unit in ZUH, 150 neonates admitted to neonatal intensive care unit (NICU) received TPN in the past (the without laminar group),and 270 neonates received TPN in the time of the study (the with laminar group)where TPN prepared with the laminar flow , All patient groups were exposed to full medical history, physical examination, Routine lab investigations ,CT and CSF culture were done for indicated cases. Results: The percent of neuro developmental delay cases were 20.7% in the without laminar group and 8.1% in the laminar group, and The percent of broncho pulmonary dysplasia cases were 30.7% in the without laminar group and were 10% in the laminar group. Also there were decrease in number of days according to stay on oxygen and stay on hospital in the laminar group. Conclusion: there were decrease in occurrence of short term outcomes like number of days of stay on oxygen and stay on hospital in the laminar group and long term outcomes like neuro developmental delay and broncho pulmonary dysplasia in the laminar group.