Background and aims The early identification of severity of illness is important for prioritising treatment to reduce mortality and morbidity in neonates but it is sometimes difficult to assess. Most of the available neonatal scoring systems have certain limitations. None of the existing scoring systems can predict neonatal outcome by assessing only clinical parameters without including any laboratory investigations. Hence this study aimed to identify high risk clincial parameters helpful in Predicting outcome of hospitalised neonates. Design and setting Prospective, Clinical, teaching hopital based observational study. Methods All the 344 neonates at admission were assessed on the basis of various clinical parameters. Statistical analysis Comparision between means by ANOVA. Odds ratio with 95% CI. Multiple logistic regression analysis, Positive and negative predictive values, sensitivity, specificity of each significant variable. significance level p ≤ 0.05. Results Variables significantly associated with mortality were: HR (OR-3.27, CI -1.56–6.83, p-0.0016), RR (OR-5.61, CI -2.26–13.96, p-0.0002), SPO2 (OR-12.17, CI -4.60–32.72, p- <0.0001), CFT (OR-24.31, CI -7.39–79.94, p- < 0.0001), hypo/hyperthermia (OR-3.58, CI -1.66–7.70, p-0.001), birth weight (OR-2.13, CI -1.05–4.33, p-0.037), sensorium (OR-21.07, CI-8.30–53.48, p-0.0001), activity (OR-44.55, CI -6.01–330.26, p-0.0002), pallor (OR-0.15, CI -0.07–0.33, p- <0.0001), cyanosis (OR-0.10, CI -0.04–0.25, p-0.0001), bleeding (OR-0.29, CI -0.10–0.80, p-0.016), dehydration (OR-4.70, CI-1.99–11.09, p-0.0004), respiratory distress (OR-2.43, CI -1.18–4.96, p-0.015), murmur (OR-0.25, CI -0.09–0.70, p-0.008), abdominal distension (OR-0.16, CI -0.07–0.33, p- <0.0001), hepatomegaly (OR-0.07, CI -0.02–0.17, p-0.0001), tone (OR-37.12, CI -8.66–158.99, p-0.0001)/ (OR-18.2, CI-2.32–142.91, p-0.005), absent Moro’s (OR-14.43, CI-5.74–36.28, p-0.0001). Conclusions Outcome of neonates can be predicted at the time of admission, using simple, easily assessed bedside clinical parameters.