Objective: Evaluate the impact of a care bundle on the incidence of necrotizing enterocolitis (NEC) in the neonatal intensive care unit. Study Design: Retrospective, single-center, population comparison of patients diagnosed with NEC before and after implementing an NEC care bundle utilizing standardized feeding protocol, donor milk program, transfusion protocol, early antibiotic protocol, and restricted indomethacin use. Result: Incidence of NEC fell from 1.92 to 0.83% (P <0.0001). Incidence of NEC in the 23-27 weeks gestation group decreased from 14.21 to 6.09% (P = 0.0009). In the 28-30 weeks gestation group, NEC incidence decreased from 5.56 to 2.10% (P = 0.0096). Significant reduction of recurrent NEC and transfusion-associated NEC was observed. Conclusion: Implementation of an NEC care bundle reduced NEC incidence, with the greatest impact seen in the most vulnerable preterm and very preterm infants.