Background: Neonatal sepsis is a leading cause of morbidity and mortality among neonates in both developing and developed countries and the clinical manifestations are non-specific. Delayed identification and inappropriate treatment are key factors causing high neonatal mortality. This study aimed to report the prevalence and pattern of neonatal sepsis from a southwestern institution in Nigeria. Methods: The study was carried out on 174 neonates admitted with risk factors and features suggestive of sepsis into the Special Care Baby Unit (SCBU) of a Tertiary Hospital over a period of one year. The babies were evaluated clinically, and blood cultures were collected from all suspected cases prior to the initiation of antibiotic therapy. Data obtained were analyzed using SPSS version 25. Statistical significance was set at p < 0.05. Results: Neonatal sepsis was responsible for 25.2% of the 294 neonates that were admitted into the SCBU over the one-year period of study. Of the 174 neonates that were clinically diagnosed with sepsis, bacterial isolates were obtained from 74 (42.5%) while 100 (57.5%) had negative blood culture. Staphylococcus aureus was the most common isolated organism. Lack of ANC (41.4%) and premature ruptured of membranes (27.6%) were the prevailing maternal risk factors while Low birth weight (57.5%) and preterm delivery (66.1%) were the most common risk factors in the neonates. Fever (27.6%), and respiratory distress (48.3%) were the most common complaints among the studied neonates. There was a statistically significant correlation between sepsis and place of birth (p <0.05). Conclusion: Neonatal sepsis remains an important threat to lives of newborns. Babies delivered in the facility (in-born) showed significant lower incidence of sepsis compared to those brought from outside the facility (out-born) where asepsis is questionable. It is paramount to advocate preventive measures for neonatal sepsis even right from antenatal periods to deliv