Neonatal sepsis remains one of the leading causes of morbidity and mortality in neonates especially in developing countries. It ranks third among the causes of neonatal deaths in Africa. In view of the reports on the changing bacterial pattern and increasing antibacterial resistance of neonatal sepsis, it is important to determine if there is a change in the pattern of neonatal sepsis from that documented by two previous studies carried out in Lagos University Teaching Hospital twenty years and eight years ago. The aim of this study was to determine the prevalence, common bacterial pathogens and the antibiotic sensitivity pattern of neonatal sepsis including the risk factors and clinical features associated with neonatal sepsis at the Lagos University Teaching Hospital (LUTH), Lagos. This was a cross-sectional study of both inborn and out-born neonates aged 0 – 28 days who presented at LUTH with risk factors and symptoms suggestive of sepsis from January 2017 to October 2017. Two hundred and ninety (290) neonates who met the inclusion criteria and whose parent(s)/guardian gave consent were consecutively recruited into the study. The sociodemographic data were documented as well as the risk factors and clinical features of suspected sepsis. The recruited neonates were first stabilised by correcting the blood sugar level in those with hypoglycaemia, providing respiratory support for those in respiratory distress, providing warmth where hypothermia was detected and maintaining circulation via intravenous fluids. Samples for blood, cerebrospinal fluid and urine cultures were taken from each recruited neonate after stabilisation before commencement of empirical antibiotics. Samples of urine and cerebrospinal fluid were collected into separate sterile universal bottles while blood was collected into a BD BACTEC™ Paediatric culture bottle. All samples were sent to the microbiology laboratory for analysis and identification of organisms within two hours of collection and sample processing commenced within 30 minutes of getting to the laboratory. Data was analysed using International Business Machine (IBM) Statistical Package for Social Sciences (SPSS) for Windows version 23 software. Data were summarized using frequency, percentages, mean, median, standard deviation, interquartile range, charts and tables. A probability value (p-value) less than 0.05 was considered as statistically significant. Five hundred and ninety six (596) neonates were admitted during the study period out of which 290 cases of suspected neonatal sepsis were recruited. Out of the 290 recruited neonates 88 (30.3%) were inborn and 202 (69.7%) were out-born. Seventy-three (25.2%) neonates out of the 290 had blood culture proven septicaemia, 1 (0.4%) had meningitis, and no neonate had urinary tract infection (0.0%). Of the 73 neonates with positive blood cultures 56 (76.7%) had early onset sepsis (EOS) and 17 (23.3%) had late onset sepsis (LOS). The prevalence of blood culture proven septicaemia was 12.2% (73/596). Gram negative bacilli (GNB) accounted for 60.3% of isolates and Gram positive cocci (GPC) 39.7%. The main organisms causing neonatal sepsis were Staphylococcus aureus (20.5%), Coagulase negative Staphylococcus (19.2%) and Klebsiella pneumoniae (13.7%). Gram positive cocci were most sensitive to vancomycin (100%), amikacin (75.9%) and levofloxacin (75.9%), while Gram negative bacilli were most sensitive to levofloxacin (86.4%) and piperacillin-tazobactam (84.1%). There was a 62.1% resistance of GPC to ampicillinsulbactam and 50% resistance of GNB to cefotaxime. All isolates (both GPB and GPC) showed high sensitivities to levofloxacin (82.2%) and amikacin (72.6%).