BACKGROUND AND OBJECTIVE: To reduce neonatal death, it should be studied the causes of it in any region or medical centers and with appropriate measures we can improve quality of health care and treatment. To achive this goal, this study was conducted in one of the 3rd referral mother-infant care level centers. METHODS: This cross-sectional study was done in intensive care unit (Nicu) of Ayatollah Rohani Hospital, affiliated by Babol University of medical science, from 2009 to 2017. The causes of neonatal death were identified based on ICD10 (International Classification of Diseases, Tenth Revision) by laboratory, clinical and Para clinical evidence recorded in patients sheets. FINDINGS: Of the total number of 4029 admitted infants in Nicu, 276 cases (6. 7%) died that 99 (35. 9%)of them died within the first 24 hours. The average annual death was 6. 7± 1. 85 and the gestational age was 29. 9± 4. 77 weeks. These infants were born with an average birth weight (g) of 1300. 5± 810. 04 and lived at average 7. 99± 10. 14 days. The most common causes of death in neonates were sepsis and DIC fallowing it 33. 4%, extreme premature less than 26 weeks 18. 4%, congenital anomalies 14. 8% and respiratory distress syndrome 14. 1%. CONCLUSION: According to the results of this study, although severe sepsis and prematurity were the most common causes of death after the first 24 hours, RDS management was more favorable than sepsis, and measures should be taken to reduce sepsis.