Background: The neonatal intensive care unit (NICU) has high-quality medical staff and tools to care for premature and sick term neonates. Epidemiological information regarding diseases, management and outcome of admitted neonates in NICU are the basis for establishing an effective intervention and adjusting the quality of health care. This study aimed to determine disease patterns, prescribed medications, resource utilization and outcome of the neonates hospitalized in NICU. Methods: Observational cross-sectional study, which included 213 neonates admitted from May 2018 to January 2019, at NICUs of obstetric and children hospitals of Zagazig University. Perinatal and demographic data, diagnosis, prescribed medications and outcome were documented and analyzed. Results: The commonest primary diagnosis during NICU admission were RDS (21.1%) followed by surgical problems (14.6%), late onset sepsis (12.2%), congenital pneumonia (8.5%), early onset sepsis (8%) and aspiration pneumonia (5.2%).All of the studied neonates received antibiotics while (97.1%) received parenteral nutrition ,(30.1%) received positive inotropes and (28.6%) received caffeine citrate. As regard the outcome, (19.2%) of the studied neonates were died and the causes of neonatal deaths were sepsis (12.2%) followed by respiratory failure (5.1%), cardiogenic shock (2.8%), surgical complications (1.9%), inborn error of metabolism (IEM) (1%) and severe hypoxic ischemic encephalopathy (HIE) (0.5%). Conclusion: RDS and surgical diseases were the most common causes of NICU admission. The antibiotics and parenteral nutrition were prescribed frequently in NICU and sepsis was the main cause of newborn mortality. Key words: NICU; neonatal admission; neonatal mortality; Sepsis