Introduction: A high MPV on admission in septic patients may be a useful indicator associated with poor outcome especially when it is associated with decreasing platelet numbers. Objective: To determine the frequency of mortality in neonates with sepsis having high MPV. Material & Method: Study design: Descriptive case series study Settings: NICU, Shifa International Hospital, Islamabad Methodology: All newborns of both genders up to 28th day of life who have culturally proven sepsis or probable sepsis with gestational age of ≥28 weeks, birth weight > 700gms were enrolled. The initial investigations on admission was carried out as per NICU septic screening protocol includes complete blood count CBC, C-Reactive Protein (CRP), electrolytes, renal function tests, blood C/S, urine R/E urine C/S, x-ray chest while the other investigations including CSF analysis, gram staining and culture, tracheal secretions and catheter tips for culture and sensitivity are performed when indicated clinically. Outcome was measured till discharge or death. Results: Mean age of the patients was mean ±SD 6.58 ±5.72 days. Most of the neonates 59 (62.1%) were males whereas 36 (37.9%) were females. Mean CRP, TLC count, platelet count, TLC count at baseline were 21.23 ±42.34, 15190.5 ±4619.32, 254348.42 ±101479.87 respectively. MPV at baseline 10.56 ±0.85 and at 48 hours was 9.96 ±0.81 respectively. Mortality was observed in 22 (23.2%) neonates. Conclusion: The frequency of mortality was found to be 23.2% in neonates with sepsis having high MPV. Keywords: Mortality, Neonates, Sepsis, Mean Platelet Volume