Background: Neonatal intestinal obstruction is a common surgical emergency associated with significant morbidity and mortality. Prompt diagnosis and appropriate intervention are essential to improve survival outcomes. Aim: To evaluate the clinicodemographic profile and outcomes of neonatal intestinal obstruction in a tertiary care setting. Methods: This prospective study included 32 neonates who presented with symptoms of intestinal obstruction and underwent surgical intervention from January 2019 to September 2023. Data on clinical presentation, surgical treatment, and outcomes were collected and analyzed. Results: Of the 32 neonates, 20 (62.5%) were male, and 12 (37.5%) were female. The most common cause of intestinal obstruction was intestinal atresia (10 cases, 31.25%), followed by malrotation (7 cases, 21.8%). The most frequent symptoms were vomiting (seen in 17 cases, 53.1%), failure to pass stool (14 cases, 43.75%), and abdominal distension (10 cases, 31.25%). A total of 25 neonates (78.13%) were successfully discharged, while the mortality rate was 21.87% (7 cases). Conclusion: Intestinal atresia is the leading cause of neonatal intestinal obstruction in this study. Early diagnosis and multidisciplinary management can significantly improve outcomes