Introduction: Neonatal sepsis remains a formidable global health challenge, constituting a significant cause of morbidity and mortality among both term and preterm infants. Our study was aimed to evaluate the importance of haematological scoring system for the early diagnosis of neonatal sepsis.

Material and Methods: Hospital-based prospective observational study was conducted over 18 months, involving 100 neonates with suspected sepsis using convenience sampling. Inclusion criteria involved neonates under 28 days old with clinical suspicion of sepsis and guardian giving informed consent. Data collected included maternal, perinatal, and neonatal clinical profiles, and haematological investigations like WBC, ANC, I/T ratio, platelet count, CRP, and blood culture using the BACTEC system. Rodwell’s haematological scoring system was employed to assess sepsis likelihood.

Results: In our study, 91% of neonates were in the early neonatal period (1–10 days), with a slight male predominance (54%). Poor feeding (66%) were the most common clinical presentation. Using Rodwell’s haematological scoring, 34% were classified as “sepsis very likely,” 31% as “possible sepsis,” and 35% as “sepsis unlikely.” CRP was positive in 78% of cases and blood culture in 52%, both showing significant association with sepsis likelihood. Platelet count, immature PMN count, and I/T ratio showed significant variation across sepsis categories.

Conclusion: Our study highlights the usefulness of Rodwell’s haematological scoring system as a cost-effective and practical tool in the early diagnosis of neonatal sepsis.

KEYWORDS: Haematological Scoring System, Infections, Peripheral Blood Smears, Total Leukocyte Count.