<p>Sierra Leone’s neonatal mortality rate is among the highest in the world. In 2022, the neonatal mortality ratio was 34 per 1000 livebirth. In Koinadugu District, little is known about neonatal mortality. we reported the magnitude, epidemiological trend, distribution, and causes of neonatal deaths at Kabala Government Hospital (KGH), Koinadugu District, Sierra Leone.</p>