Background Neonatal septicaemia remains one of the leading causes of morbidity and mortality both among term and preterm infants. signs and symptoms of neonatal sepsis are nonspecific.[3] These include fever or hypothermia, respiratory distress including cyanosis and apnea, feeding difficulties, lethargy or irritability, hypotonia, seizures, bulging fontanel, poor perfusion, bleeding problems, abdominal distention, hepatomegaly, gauiac-positive stools, unexplained jaundice Neonatal sepsis is of two types: Early onset Sepsis (EOS): Early onset sepsis presents within first 72 hours of life Late onset Sepsis (LOS): Late onset sepsis usually presents after 72 hours of age. The source of infection is either nosocomial or community acquired and neonates usually present with septicemia, pneumonia or meningitis Material and Methods A prospective and observational study was carried out Ayaan institute of Medical Sciences. A total of 130 febrile subjects aged up to 28 days with clinical features such as Babies with birth asphyxia and congenital anomalies were excluded from the study Result: The most common symptoms seen were lethargy and refusal of feeds in 61.66% and 55.9% respectively, followed by apnoea and respiratory distress in 34.17% and 21.67% respectively. Vancomycin and colistin showed 100% efficacy against Gram-positive isolates while amikacin, meropenem and linezolid was found to be most effective among Gram-negative isolates in both EOS and LOS. Conclusion: The clinical features of neonatal sepsis being non-specific, pose a great challenge for prompt diagnosis. Lethargy, refusal of feeds and apnoea were the most common clinical features in this study. Klebsiella was the predominant gram-negative organism and Staphylococcus aureus and CONS were the predominant gram-positive isolates from blood culture in EOS and LOS.