Ninety-nine cases of neonatal septicaemia prospectively seen over a 3-year period in a large cosmopolitan African city of high altitude is presented. An incidence of 6.5 per 1000 live births was noted. Though the most important pathogens were Klebsiella spp. and Staphylococcus aureus, Citrobacter difficile and Alkalegenes faecalis were the pathogens associated with a high mortality rate. Low birth weight infants were significantly more affected. The overall mortality rate was 27.3 per cent. The commonest predisposing perinatal factors were birth asphyxia and prolonged rupture of fetal membranes. On the basis of the trend of organisms isolated and their sensitivity pattern, it is suggested that the initial use of gentamicin alone is satisfactory.