<strong>Background</strong>: Neonatal tumours, occurring within 28 days of life, are associated with a favourable outcome in high-income countries. Limited data are available on neonatal tumours in low- and middle-income countries.<br /><strong>Aim</strong>: We aimed to create awareness of neonatal tumours in a middle-income country, by identifying the most common tumours diagnosed to determine whether there was a delay to presentation or diagnosis at the Paediatric Oncology unit, to identify possible areas of improvement and increase overall survival. Setting: Chris Hani Baragwanath Academic Hospital Paediatric Oncology unit. <br /><strong>Methods</strong>: A retrospective case series was performed collecting data on 60 neonates diagnosed with a tumour over a 25-year period (1 January 1988 to 31 December 2012). Descriptive statistical analysis using percentages and medians were used. Kaplan–Meier analysis was used to calculate survival. <br /><strong>Results</strong>: Germ cell tumours were identified as the most common neonatal tumours diagnosed 29/60 (48.3%), whereas malignant soft tissue tumours were the most common malignant tumours identified. The median delay to presentation was 7 days, the median diagnostic delay was 11 days and the median overall delay was 30 days. The overall 5-year survival rate was 67.3%, with an overall 5-year survival of 54.1% of neonates diagnosed with a malignant tumour. <br /><strong>Conclusion</strong>: A large percentage of neonates diagnosed with malignant tumours in highincome countries can be successfully treated and cured. Clinicians involved in the care of neonates need to be better acquainted with disease-specific signs of neonatal tumours to allow for early detection and referral to a Paediatric Oncology unit.