Background: In a gastrointestinal emergency, neonatal surgery is a very challenging and difficult task causing high morbidity and mortality. In Bangladesh, the frequencies of such emergency management are not very available. For this reason, we do have not enough research-based information regarding the outcomes and effectiveness of major neonatal gastrointestinal emergency management. Aim of the study: The aim of this study was to assess the outcomes and effectiveness of major neonatal gastrointestinal emergency management. Methods: This prospective observational study was conducted in Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh during the period from January 2018 to December 2018. In total 35 neonates with gastrointestinal emergency treated in the mentioned hospital were included as the study subjects for this study. A predesigned questionnaire was used in data collection. All data were processed and analyzed and disseminated by using MS Office and SPSS version 23 programs as per need. Results: In this study, as palliative procedures, Sigmoid colostomy, Transverse colostomy, Gastrostomy, Ileostomy were applied in 26%, 17%, 14%, and 6% of participants respectively. Besides these, as definitive surgical procedures Perforation repair and Exploratory lap with release of the band were applied in 20% and 14% of patients respectively which were noticeable. In outcome analysis, we observed, as the incidences of postoperative complication sepsis, wound infection, anopia, and anal stenosis occurred in 14%, 11%, 6%, and 3% respectively. Finally, in this intervention occurrence of death was found at 26%. Conclusion: Now a day, pediatrics surgery has evolved as a specialty within the province of general surgery. But till now, the management of neonatal gastrointestinal emergencies is a very complex and difficult task for any physician or a team of physicians in any part of the world. Prompt patient transportation, earlier primary diagnosis and the arrangement of modern treatment facilities, and arranging high-tech medical equipment can save a lot of babies from such health issues as gastrointestinal emergencies.