Background: Neonatal sepsis is a systemic inflammatory response syndrome in the presence of infection during the first 28 days of life. Globally every year about 4 million children die in the first 4 weeks of life, of which 99% of the deaths occur in low and middle income countries. In Ethiopia it is one of the most common causes of neonatal death. Identification of the determinants for neonatal sepsis is not adequate in low income countries like Ethiopia especially in southwest part of the country.