Background: Birth asphyxia is a failure to initiate and sustain breathing at birth. Birth asphyxia can lead to severe hypoxic organ damage to heart, lungs, liver, gut, kidneys, but brain damage is the concern, because mostly not totally reversed to its pre-event function. But there is a gap to know short term outcomes of perinatal asphyxia in FHCSH. Objectives: To assess short term outcomes and causes of perinatal asphyxia among neonates admitted to FHCSH. Methods: Institution based cross sectional study was used on 314 neonates admitted to FHCSH, from September, 2017 to February, 2019 G.C. The data was collected on October, one to ten, 2019. The whole population admitted to the hospital was included in the study. Chart review was done for each consecutive case by using the already adapted checklist.The data was coded and entered to the SPSS 20 version and basic descriptive stastical analysis was done. Result: there were a total of 314 perinatal asphyxia cases were admitted to the hospital in the study period. Death rate was high in this study 101(32.2%) from all studied subjects. Neonates with sarnat clinical stage Ⅲ perinatal asphyxia has poor prognosis with 27(31%) survival rate and 5(38.4%) of survivors discharged with sequelae, while Good short term outcome was seen in cases with sarnat clinical stage Ⅰ with 100% survival and discharged without sequel. Most perinatal asphyxia cases were labelled as stage Ⅱ 208(66.2%) in this study. Most mothers were gave birth via SVD 193(61.5%) and also males were mostly affected 192(61.1). Most of the study subjects were term 270(86%) and 218(69.4%) cases having NBW. Conclusion: the mortality rate of perinatal asphyxia was high. In this study mortality is associated with sarnat and sarnat clinical staging, complications of perinatal asphyxia, prematurity, home delivery and BW less than 2500grams.Therefore it is better to prevent perinatal asphyxia rather than treating after as well as preventing premature delivery and also prevent it’s complication. Key words: perinatal asphyxia, short term outcome, causative factors of perinatal asphyxi