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Neonatal survival in resource-limited countries is much lower than in industrialized nations. Twin pregnancies and breech presentations are at higher risker for poor neonatal outcomes. Birth asphyxia and prematurity are the two of the leading causes for neonatal deaths. Risks factors for stillbirths and early neonatal deaths such as post-term pregnancy are discussed. Treatment of birth asphyxia with hypothermia is highlighted as well as treatment of respiratory distress syndrome (RDS) with bubble CPAP. Specific patient case scenarios from the Zimba Mission Hospital Neonatal Intensive Care Unit (NICU) have been collected. Cost-effective strategies modified for the developing world can improve neonatal outcomes.