Background Neonatal intensive care units (NICU) are specialized units that provide medical attention to neonates, and thus have become a vital aspect in the provision of critical care to infants who are faced with special challenges following birth. Aim To determine antepartum and intrapartum factors that predispose to NICU admissions in the Nandom Municipal of the Upper West Region of Ghana. Method This was a cross‐sectional retrospective study, spanning from January 1, 2021 to December 31, 2021. Records covering 1777 women who were delivered or had their babies referred to the St. Theresa's Hospital in the Nandom Municipality were involved in the study. Descriptive statistics and multinomial logistic regression analysis were used to compare variables, and statistical significance was determined where the p‐value was less than 0.05. Results From the study, the rate of NICU admission was 10.4%. There was a significant association between mothers who attended less than four antenatal sessions ( p = 0.004) and admission to NICU. Nulliparous mothers ( p = 0.027) and mothers who presented with multiple pregnancy ( p < 0.001) were more likely to have their babies sent to NICU. Both preterm delivery ( p < 0.001) and post‐term delivery ( p < 0.001) were prone to admission to NICU. Also, instrumental delivery ( p < 0.001), cesarean section ( p < 0.001), low birth weight ( p < 0.001), and male infants ( p = 0.003) had an increased risk of being admitted to NICU. Furthermore, severe ( p < 0.001) and moderate ( p < 0.001) birth asphyxia in the first minute following delivery were significantly associated with NICU admission whereas severely asphyxiated babies at 5 min ( p < 0.001) were associated with NICU admission. Conclusion The study revealed a relatively high NICU admission rate in the study area, and the predictors are multifaceted. Tailored intervention programs aimed at curbing these predictors will be required to reduce the rate of NICU admissions in the Nandom Municipality of Ghana.