Abstract: 　Objective　To explore the risk factors of mortality in neonates with severe bacterial pneumonia. Method　The clinical data of 249 neonates with severe bacterial pneumonia from January 2011 to November 2015 were analyzed retrospectively, and the related factors of mortality were analyzed. Results　Of the 249 children, 45 died and mortality rate was 18.07%. A total of 251 strains of pathogenic bacteria were detected in the bacterial culture, and the top 5 pathogens were Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus pneumoniae and Staphylococcus epidermidis. Univariate analysis showed that the gestational age, premature rupture of membranes, age at the time of hospital admission, birth weight, feeding, Apgar score, total bilirubin, complications, traumatic treatment, parenteral nutrition, and multidrug-resistant bacteria infection between the death group and survival group were significantly different (all P<0.05). Multivariate logistic regression analysis showed that the age at admission <7 days (OR=4.30, 95%CI: 1.74~10.64), Apgar scores <7 (OR=3.24, 95%CI: 1.23~8.49), and having complications (OR=6.81, 95%CI: 2.65~17.46), multidrug-resistant bacteria infection (OR=6.16, 95%CI: 1.90~19.99) and traumatic therapy (OR=3.82, 95%CI: 1.03~14.16) were the independent risk factors of mortality in neonatal severe bacterial pneumonia (all P <0.05). Conclusion　The mortality rate of neonatal severe bacterial pneumonia is relatively high. And the main risk factors of death were the age at admission <7 days, Apgar scores <7, and having complications, multidrug- resistant bacteria infection and traumatic therapy.