Background: Globally, neonatal mortality remains a serious catastrophic problem of newborns, particularly in a low-resource setting. Reports in the world and Sub Saharan Africa had been substantial decrement of neonatal mortality but Mini Ethiopian Demographic Health Survey and occasional reports in my study area were high which lack scientific research which used to validate this high rate of neonatal mortality report at neonatal intensive care unit. Objective: This study aimed to determine survival and predictors of neonatal mortality at the Neonatal Intensive Care Unit of Felege Hiwot Comprehensive Specialized Hospital from 2016 to 2020, Northwest Ethiopia, 2021. Methods: A retrospective follow-up study was conducted among 870 admitted neonates from January 1, 2016 to December 31, 2020 in the NICU by simple random sampling technique. Data was entered into Epi-Data version 3.1 then export to STATA version14. A Log-rank test was used to compare the survival experience of explanatory variables. Finally, the Kaplan Meier curve and Cox proportional hazard model were used to estimate neonatal survival status, and identify predictors of neonatal mortality respectively. Results: The incidence rate of neonatal mortality was 28.13/1000 neonate-days with a median survival time of 26 days. In this study, rural residence(AHR: 2.23, 95% CI: 1.52, 3.36), home delivery(AHR: 3.73, 95% CI: 2.13, 6.53), low APGAR score (AHR: 2.73, 95% CI: 1.84, 4.04), birth asphyxia(AHR: 2.04, 95% CI: 1.39, 3.01), respiratory distress syndrome(AHR: 1.67, 95% CI: 1.14, 2.42), ambu-bag resuscitation(AHR: 0.45, 95% CI: 0.23, 0 .88), glucose(AHR: 0.54, 95% CI: 0.39, 0.76), and oxygen (AHR: 0.51, 95% CI:0 .35, 0.75) were significant predictors of time to neonatal death. Conclusion: Up on this study, there was high incidence rate of neonatal mortality. Rural residence, home delivery, low APGAR score, birth asphyxia, respiratory distress syndrome, and neonates who were got glucose, resuscitation and oxygen were important predictors of neonatal mortality. Therefore, all stake holders shall give due attention to reduce neonatal mortality at the Neonatal Intensive Care Unit of Felege Hiwot Comprehensive Specialized Hospital. Key words: Neonatal Mortality, Neonatal Intensive Care Unit, Northwest Ethiopia, 2021.