Purpose: India is a major contributor to neonatal deaths worldwide. There is a paucity of amenities for the management of neonatal health issues in rural areas of our country. Hence, there is a need to invent a reliable scoring system for the analysis of neonatal mortality.Aim: The aim of the study is to evaluate the Modified Sick Neonatal Score (MSNS) as a predictor of mortality in neonatal care units in resource-limited settings.Materials and methods: This cross-sectional observational study was performed in the intensive care unit of our hospital. All the data were collected and analyzed using IBM Corp.'s Statistical Package for Social Sciences (SPSS) software.Results: Overall, 71 participants were considered for the present study. The common clinical diagnoses noticed in our participants were meconium aspiration, malformation, and jaundice. The MSNS score compared between expired and discharged participants is found to be statistically significant with p<0.05.Conclusion: The MSNS scoring system is considered an ideal scoring system for detecting early mortality in neonates.