Abstract Background: Globally about 4 million neonates died each year within 28 days of life. Low birth weight is still continued global public health problem and it has both short and long term health impact. According to UNICEF report each year 1.1 million neonates die due to complication of preterm birth. Prematurity, birth complication, neonatal sepsis, meningitis and pneumonia were the main determinant of neonatal mortality. Of the cause of neonatal mortality low birth weight covers 60% to 80%. Objective: The aim of this study was to assess neonatal mortality and associated factors among low birth weight neonates admitted to neonatal intensive care unit in selected hospitals, Amhara region North West Ethiopia 2018. Methods: An institutional based cross sectional study was conducted. The study was conducted from July 1/2017 to June 30/2018. One year data were collected retrospectively from November1 to November30/2018, entered into Epi Info version7 software and exported to SPSS version23software for analysis. Both Bi-variate and multivariable logistic regression analysis was carried out. Adjusted odds ratio with 95% CI was used to measure strength of association. Results: A total of 635 low birth weight neonates were incorporated in the study. Number of male participants were371 (58.4%). Among these low birth weight neonates 161/635 death were recorded with 253.5 per 1000 low birth weight live birth and the prevalence was 25.4%. In multivariable logistic regression analysis gestational age below 32 weeks (AOR: 3.83, 95%CI: 2.18-6.72), presence of asphyxia (AOR: 2.27, 95%CI: 1.17-4.39), presence of congenital abnormality (AOR: 2.29, 1.05-4.99), Presence of respiratory distress syndrome (AOR: 2.831,95CI: 1.99-4.23), history of maternal TT vaccination (ARO: 0.55, 95%CI: 0.33-0.93) history of maternal high risk (AOR:1.72,95%CI: 1.078-2.748), presence of hypothermia (AOR: 1.64, 95%CI: 1.08-2.49) and presence of anemia (AOR: 4.28, 95%CI: 1.19-15.46) were significantly associated with neonatal mortality. Conclusion and recommendations:-In this study neonatal morality was high (95%CI: 22.2-28.7). Gestational age below 32weeks, maternal TT vaccination, asphyxia respiratory distress syndrome, hypothermia, maternal high risk and anemia had significant association with neonatal mortality. Community and institutional based quality of health care delivery system and awareness creation should be emphasized. Key words: Neonatal mortality, low birth weight, neonatal ICU, Amhara Region, North West Ethiopia