Objectives: To identify the risk factors and evaluate the early neonatal outcomes of premature infants in Duhok Hospital for Obstetrics and Gynecology, a tertiary center in Kurdistan Region - Iraq. Methods: This cross sectional study was carried out from September 1/2021 to December 31/2021. Four hundred participants were recruited, 200 were preterm and 200 were term. The participants were examined and followed till delivery. Multivariable logistic regression analysis was used to identify the risk factors for preterm delivery. Results: The risks factors for preterm delivery were maternal age ≥ 35 years (AOR 3.32; 95 % CI 1.12-9.86), nulliparity (AOR 2.14; 95 % CI 1.25-3.67), history of preterm birth (AOR 6.51; 95 % CI 1.99-21.28,), no ANC (AOR 3.01; 95 % CI 1.32-6.87), < 4 ANC visits (AOR 1.92; 95 % CI 1.12-3.30), PROM (AOR 4.71; 95 % CI 2.71-8.16), antepartum hemorrhage (AOR 9.25; 95 % CI 1.81-47.39), hypertensive disorders in pregnancy (AOR 2.30; 95 % CI 1.12-4.71) and anemia (AOR 3.51; 95 % CI 1.86-6.63). Preterm delivery is linked to poor early neonatal outcomes. Conclusions: Early identification of women at risk for preterm delivery by health care providers is essential to prevent preterm delivery