Background: Neonatal near miss is defined as a neonate who approximately died but survived from an extremely complicated circumstance that occurred during pregnancy, birth, or within 0-28 days of life. Meta-analysis in Ethiopia shows that NNM is high which in turn contributes the neonatal mortality among public health problems in Ethiopia. To scale up a comprehensive way of implementation to reduce neonatal mortality evaluation of determinant factors for neonatal near-miss cases is very important. Even though some studies were done in assessing near-miss cases, they failed in identifying the health system-related and behavioral factors that determine neonatal near misses. Therefore, this study attempted to identify the determinants of neonatal near misses among neonates admitted at Bahir Dar city governmental hospital to fill those gaps in the aforementioned studies. Objective: To identify determinants of neonatal near misses among neonates admitted at Bahir Dar city governmental hospitals, North West, Ethiopia, 2022. Methods: Institutional based unmatched case-control study design was conducted in the Bahir Dar city governmental hospitals on a total of 443 neonates(147 cases and 296 control) neonates. Cases were recruited consecutively as they present until the required sample size was reached whereas controls were selected by a systematic sampling method. Data were collected by using a pre-tested structured interviewer-administered questionnaire at discharge. Besides, data related to clinical diagnosis and management were extracted from patients' cards and downloaded from epicollect5 into excel, and then imported to SPSS version 26. Both bivariable and multivariable binary logistic regression was run at 95% CI to identify determinants of neonatal near misses and the final model was checked by the Hosmer and Lemeshow goodness of fit test and variables having P- value less than 0.05 was taken as determinant factors. Result: Neonates who didn't get exclusive breastfeeding within an hour of delivery [AOR=3.13, 95% CI: (1.25, 7.83)], having a history of pregnancy-induced hypertension [AOR=5.55, 95% CI: (2.34, 12.85)], less than four Antenatal care visit [AOR=8.38, 95% CI: (3.62,019.44)] and travel more than an hour to reach health facilities from home [AOR=6.55, 95% CI: (2.56, 16.78] were the determinants of neonatal near miss. Conclusion and recommendation: Delayed initiation of exclusive breastfeeding, pregnancy-induced hypertension, time to reach to health facilities from home, and antenatal care visits were determinants of the neonatal near miss. Therefore, increasing maternal health services like exclusive breastfeeding practice, and antenatal visit uptake, enhance the accessibility of ambulance service and priority for neonates mothers with pregnancy-induced hypertension Keywords: Determinants, neonatal near misses, governmental hospitals, Bahir Dar