Objective: To asses the role of Triggering receptor expressed on myeloid cells-1 (TREM-1) as a potential early diagnostic marker of neonatal sepsis. Methods: Studied neonates were evaluated for sepsis using clinical and laboratory measures. sTREM-1 was measured in the serum by Enzyme Linked Immunosorbant Assay(ELISA)on admittion& 48 hour after antibiotic therapy.Another 10 blood samples from healthy neonates age & sex matched to cases were analysed for sTREM-1 as a control group. Results: Baseline sTREM-1 levels were significantly elevated in septic neonates (1011.1 ± 594.93 pg/mL) compared to controls (136.6 ± 41.3 pg/mL). Septic preterm neonates had significantly higher sTREM-1 compared to full term neonates. sTREM-1 was significantly decreased 48 h after antibiotic therapy compared to baseline sTREM-1. The cutoff value of 250pg/mL could be diagnostic for neonatal sepsis(NS) with 97.1% sensitivity and90% specificity (AUC,0 .97).