Introduction: Newborn period is the most vulnerable phase of life and deaths during first 28 days of life account for 70% of all infant deaths and 56% of all deaths of under-5 year in children. Children who die within the first 28 days of birth suffer from conditions and diseases associated with lack of quality care at or immediately after birth and in the first few days of life. Aim: To study the morbidity and mortality profile of neonates admitted in Special Newborn Care Unit (SNCU) in a tertiary care hospital. Materials and Methods: This hospital-based retrospective study was carried out in SNCU, Department of Paediatrics, Gauhati Medical College and Hospital (GMCH), Guwahati, Assam, India. The study period was from 1st July 2021 to 30th June 2022. A total of 7439 neonates (both inborn and outborn) from birth to 28 days of life admitted in SNCU during the study period were included in the study. Morbidity and mortality data of admitted neonates were collected from the monthly reporting format and patient records and compiled in MS Excelsheet and analysed using arithmetic mean and also expressed in percentages. Results: During the study period, 7439 neonates were admitted in SNCU, inborn 4854 (65.3%) and outborn 2585 (34.7%). Male and female 4305 (57.9%) vs 3134 (42.1%). Normal birth weight and Low Birth Weight (LBW) babies 4200 (56.5%) vs 3239 (43.5%). Term and Preterm (PT) babies 4424 (59.5%) vs 3015 (40.5%). Neonatal jaundice, birth asphyxia and neonatal sepsis were common morbidities requiring admission. Mortality was 12.1% which was higher in outborn (21.5%) than inborn (7.1%). Birth asphyxia (45.3%) was the commonest cause of mortality followed by Respiratory Distress Syndrome (RDS) with prematurity (20.4%) and neonatal sepsis (15.1%). Birth asphyxia was higher in outborn (47.5%) than inborn (41.9%). Neonatal sepsis was higher in outborn (18.3%) than inborn (9.9%). Highest number of death occured within seven days of birth (70.2%) and among LBW babies (61%). Conclusion: Birth asphyxia, RDS with prematurity and neonatal sepsis are common causes of neonatal mortality. Outcomes of this study can be used for improving the existing healthcare services to reduce neonatal mortality.