Objective To explore the condition and trends of neonatal mortality of Gansu from 2004 to 2011 and to propose protective measures to reduce neonatal mortality. Method Mortality monitoring data of children under 5 years old form 2004 to 2011 were analyzed to obtain neonatal mortality trends. Results The neonatal mortality of 2004-2011 was 9.73‰.The rates in rural area(15.62‰) was significantly higher than that in urban area(6.77‰) ( χ²=20.172, P<0.05).Compared to 2004, the neonatal mortality of urban, rural area and the total province decreased by 9.40%, 11.77% and 10.36%, respectively.The mortality of neonatal and post-neonatal was 8.08‰ and 1.65‰, respectively.The neonatal mortality in rural area(12.76‰) was significantly higher than that in urban area(5.72‰).The main causes of neonatal death were newborn asphyxia, premature birth, low birth weight, birth defects, pneumonia and infection. Conclusions The neonatal mortality was significantly decreased, but still higher than the national average.The rates showed difference between urban and rural area.The quality of obstetric work and perinatal care should be improved to reduce the neonatal mortality.