Background: Neonatal sepsis remains one of the leading causes of neonatal morbidity and mortality worldwide, particularly in low- and middle-income countries. It is characterized by systemic infection occurring within the first 28 days of life and is associated with significant complications, prolonged hospitalization, and increased healthcare costs. Early diagnosis and prompt initiation of appropriate antimicrobial therapy are essential to improve survival.Objective: To evaluate the demographic characteristics, clinical presentation, microbiological profile, laboratory findings, risk factors, treatment modalities, complications, and outcomes among neonates admitted with sepsis to a neonatal intensive care unit (NICU).Methods: A retrospective observational study was conducted among 210 neonates admitted to the NICU with clinically suspected or culture-proven neonatal sepsis over an 18-month period. Maternal risk factors, neonatal characteristics, laboratory investigations, blood culture reports, treatment, complications, and clinical outcomes were analyzed.Results: The mean gestational age was 35.8 ± 2.7 weeks, and the mean birth weight was 2.34 ± 0.71 kg. Early-onset sepsis accounted for 58.1% of cases, while late-onset sepsis accounted for 41.9%. Prematurity (46.2%), low birth weight (52.4%), prolonged rupture of membranes (28.1%), and birth asphyxia (18.6%) were common risk factors. The predominant organisms isolated were Klebsiella pneumoniae (24.8%), Escherichia coli (18.6%), Staphylococcus aureus (16.2%), and coagulase-negative staphylococci (13.3%). Mechanical ventilation was required in 22.9% of neonates, and overall mortality was 11.4%.Conclusion: Prematurity and low birth weight remain the strongest risk factors for neonatal sepsis. Early diagnosis, appropriate antibiotic therapy, infection control practices, and comprehensive neonatal intensive care significantly improve survival.