Background: In high risk neonates’ incidence of hypoglycemia is up to 30%. There is limited evidence-based consensus regarding screening and management of neonates at risk of hypoglycaemia. Aim: The aim of the present study determine the clinical profile of hypoglycemia in newborn. Material and methods: This prospective observational study was done the Department of Paediatrics, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India, from January 2017 to December 2018. 100 Patients admitted in NICU with blood glucose less than 45 mg/dl were included in this study. In neonates with risk factors blood sugar was screened at 2, 6, 12, 24, 48 and 72 hours of life or whenever symptoms suggestive of hypoglycemia developed in any neonates and for critically sick neonates blood sugar was screened in every 6 hour in active phase of illness. Results: The prevalence of hypoglycemia was 100 (15.38%). Among the 100 neonates with hypoglycemia, 59 (59%) were males and 41 (41%) were females. Among the study population 85 (85%) of neonates had at least one risk factor (maternal/neonatal) and 15 cases (15%) had no risk factor. The maternal risk factors that were associated with hypoglycemia were 17% had GDM, 12% had PIH and 2% had PROM as maternal risk factors. 69% had no maternal risk factor. The neonatal risk factors associated with hypoglycemia were prematurity (27%), SGA (30%), LGA (6%), IDM (21%) and comorbidities (sepsis, birth asphyxia, polycythemia and shock) were present in 16% of the hypoglycemic neonates. Out of 100 children with hypoglycemia 63 (63%) were asymptomatic and 37 (37%) presented with symptoms. The common symptoms were poor feeding (70.27%), lethargy (18.92%), jitteriness (10.81%), irritability (5.40%), hypotonia (2.70%) and cyanosis (2.70%). 29% of neonates presented with hypoglycemia on day 1 of life, 26% of neonates on day 2, 22% on day 3 and 23% beyond 72 hours of life . Conclusion: Blood glucose screening in neonates with this risk factor is mandatory as many of the neonates were asymptomatic. The importance of early initiation of breast feeding to prevent hypoglycemia should be emphasized.