Background: Prematurity is a common but understudied cause of neonatal admissions and mortality in Nigeria. This study aimed to determine the pattern and outcome of premature neonatal admission in a southwestern institution in Nigeria. Methods: The study was a retrospective study conducted among twenty-eight preterm neonates admitted to the special care baby unit between December 2024 and July 2025. Sociodemographic data of mothers and clinical details of neonates were extracted from their case notes. Data obtained were analyzed using SPSS v25. Results: The 28 premature neonates that were studied aged between 1 hour and 23 days at admission. Five (17.9%) had estimated gestational age less than 28 weeks, 12 (42.8%) between 28 - 31 weeks and 11 (38.3%) between 32 - 36 weeks. Eighteen (64.3%) were delivered per vagina and 10 (35.7%) by caesarian section. Birth weights ranged between 0.82 – 3.00kg. Ten (35.7%) preterm deaths and 2 (7.1%) maternal deaths were recorded among the 28 neonates. Preterm deaths were more significantly associated with maternal mortality. (P = 0.04). Conclusion: Prematurity is a significant cause of admission and death in the neonatal age group. Strategies and interventions to prevent preterm deliveries and death need to be engaged urgently in both the management of premature babies and their mothers.