Neonates are easily prone for bacterial infection. Diagnosis of neonatal septicemia may be difficult as the early signs of sepsis may be subtle and different at different gestational ages. The present study was undertaken to assess the significance of the hematological scoring system (HSS) for early detection of neonatal sepsis. About 50 peripheral blood smears of all newborns collected were analysed for neonatal sepsis using the HSS of Rodwell et al. (J Pediatr 112:761–767, 1988). Analysis in our study found that an abnormal immature to total neutrophil ratio (I:T) followed by an abnormal immature to mature neutrophil ratio (I:M) were the most sensitive indicators in identifying infants with sepsis. The HSS is a simple, quick, cost effective tool which can be used as a screening test for early diagnosis of neonatal sepsis.