Background: Septic arthritis is not a common manifestation of neonatal infection but devastating if not detected or treated early. Its initial sign symptoms are nonspecific. Bacteria responsible for septic arthritis are changing from time to time as most of the cases of neonatal septic arthritis arise as a consequence of bacteremia. Aim: To highlight the magnitude of septic arthritis in neonate. Materials and Methods: A retrospective observational study was done in neonatal unit of Dhaka Shishu (Children) Hospital from October 2019 to March 2020. The medical records of those neonates were looked for prenatal, natal and postnatal history and examination findings. The onset of joint involvement, type of joints and number of joint affected was recorded as well as general and local symptoms were also recorded. All investigations were done including X ray and USG of joint. Results: Total 1903 neonates were admitted over 6 months. Among them 18 neonates were diagnosed as septic arthritis. In our study 58.8 % neonates were preterm, mean age of admission was 21.5±5 days and most common risk factor was nosocomial infection. They commonly (17 patients) presented with tenderness and limitation of movements. Among the involved joints 15 were knee, 3 hip and 1 shoulder joint. Twelve patients had positive blood culture, 10 patients had joint effusion evident by USG. Conclusion: All septic neonates should be looked for arthritis as its prevalence is not rare.

Keywords: Neonate; Septic arthritis. Key Message: All neonates with sepsis have to search for any joint manifestation present or not because neonatal septic arthritis is not very uncommon in our setup and need early diagnosis and treatment to avoid any devastating condition.