BACKGROUND- Neonatal bacterial meningitis is inflammation of the meninges due to bacterial invasion. Signs are those of sepsis, central nervous system irritation. The diagnosis of meningitis was based on either the presence of bacteria in the cerebrospinal fluid (CSF) or CSF with an increase in the number of cells (>20 cells/mm3), predominance of Neutrophils, increase in the concentration of protein (>100 mg/dL) and reduction in the concentration of glucose (<50% of the concomitant glycemia). Without treatment, the mortality rate for neonatal bacterial meningitis approaches 100%. With treatment, prognosis is determined by birth weight, organism, and clinical severity. Mortality rate for treated neonatal bacterial meningitis is 5 to 20%.. OBJECTIVE –The main objective of this study was to assess proportion of bad treatment outcome and its associated factors among neonates admitted for meningitis at TGSH from January 01/2019 to August 30/2020 . METHOD-A hospital based cross sectional study design was conducted .All neonates who had meningitis included in the study. Structured checklist used to collect the necessary data and the collected data entered, cleaned and analyzed by IBM SPS Version 25. Bivariate logistic regression was used to see for any association and P-value of less than 0.05 at 95% confidence interval was taken to determine statistical significance. Results: one thousand two hundred chars of neonates reviewed and 82 neonatal meningitis found and included in this study. Among the 82 neonates with meningitis 54.9% diagnosed meningitis after 7days of postnatal age and 53.7% are from urban areas. Out of 82 neonates with meningitis 65 (79.27%) cured ,8(9.7%) died and 9 (10.98%) discharged home with complication(hydrocephalus). Among those who had bad outcome 7 (29.2%) had health care associated infection ,8(15.7%) had late onset sepsis and 2(28.6%) had early onset sepsis. Being from rural area AOR 9.87( 95%CI,1.25-77.73) and treatment with vancomycine and ceftacizidime AOR 25.70(95%CI ,3.27-202.02)has increased odds ratio for bad treatment out-come. Conclusion: Mortality of neonatal meningitis is 10.9% and those who acquire meningitis through health care associated infection has high probability of bad treatment outcome(29.2%. Being from rural area and treatment with vancomycine and ceftazidime is found to be associated factors for bad treatment outcome. Recommendation: Neonates with meningitis who is at risk of bad treatment outcome should be identified early and managed properly.Prevention of health care associated infection is the main way of prevention of bad treatment outcome. Key words: neonatal meningitis , CNS infection