Objectives: The main aim is to determinate the incidence and leading causes of early neonatal deaths (END) during the period of ten years (2005-2015). Methods: Data for this study were retrospectively collected from birth protocols of Neonatal Unit in UKC Tuzla. The analysis included variables such as the numbers of live births, causes of death, gender, gestational age, weights at birth and ages in moment of death. Results: During the period of ten years (2005-2015) there were 46708 live births and 316 early neonatal deaths recorded.Overall the early neonatal mortality accounted for 6.7 per 1000 live births.The END rate had decreased between the years 2005 and 2015(7.8 to 4.4 per 1000 live births).Out of 316 ENDs, 196 were male infants,which is 24 % higher than the number of female infants (120).According to gestational age, the highest early neonatal mortality rate (75%) was recorded in low birth weight infants (<2500 gram).Most ENDs were noted within the first 24 hours of life (52.8 %), 24-72 hours (33.9 %),>72 hours(13,3%).The most frequent cause of this death during the study period was prematurity,particularly in male infants with gestational age under 37 weeks and birth weight between 500 and 1500 grams.Other common causes of death were congenital anomalies in 68 cases(21.5 %), hypoxia and trauma in 56 cases(17.7%) and infection in 30 cases (9.5%).The cause of END was unknown for 1.3 %. Conclusion: According to the decreasing trend in END rate, the expected rate in year 2016 is 4.01/1000. Advancements in essential neonatal care, particularly for premature infants could lead to significant decrease in END rate.