Objective To explore the causes of neonatal death in Zhongshan city from 2003 to 2012,and to provide a basis for further reducing neonatal mortality rate in Zhongshan city. Method Relevant data of death form obstetrics quality report and neonatal death registration in Zhongshan city from 2003 to 2012 were analyzed retrospectively. Results 1) A total of 1 463 neonates died from 2003 to 2012 in Zhongshan City,mortality was 3.22‰,the early neonatal death was 669 cases,mortality was 1.47‰; Early neonatal death was 45.73% of neonatal death.2)The top three death causes were:asphyxia in 295 cases(20.16%),premature and low birth weight in 293 cases (20%),congenital abnormality in 194 cases (13.26%),including congenital heart disease in 88 cases (6.02%).3)The incidence of premature was 4.10% and of asphyxia was 1.77% in recent ten years of Zhongshan city.Compared before and after 5 years:the neonatal mortality rate in Zhongshan City dropped from 4.04‰ to 2.41‰; The incidence of premature increased from 3.66% to 4.34%,premature mortality declined from 0.77‰ to 0.50‰; Birth asphyxia rate dropped from 2.34% to 1.42%,asphyxia mortality dropped from 0.91‰ to 0.42‰; Birth defect mortality dropped from 0.56‰ to 0.30‰.4) The 43 infants (12.13%) with "severe asphyxia" in perinatal deaths of Zhongshan city from 2007 to 2011 were case reviewed,including 34 cases with amniotic fluid pollution (62.79%). Conclusions To establish the health administrative departments as the leading mechanism,maternal and child health care system,medical management,clinical departments should cooperate closely to improve prenatal,intrapartum maternal and child care measures,strengthen the local perinatal workers skills training,focus on the control of early neonatal death,which can effectively reduce the neonatal mortality.