The neonatal mortality rate (NMR) decreased from 52 per 1000 live births in 1990 to 28 per 1000 live births in 20131 .The slower decline has led to increasing contribution of neonatal mortality to infant and under-five mortality. Among neonatal deaths, the rate of decline in early neonatal mortality rate (ENMR) is much lower than that of late NMR. Similarly, the perinatal mortality is also still fairly high. The rate of decline in NMR, and to an extent ENMR,has accelerated with the introduction of National Rural Health Mission in mid- 2005. Almost all states have witnessed this phenomenon, but there is still a huge disparity in NMR between and even within the states. The disparity is further compounded by rural–urban, poor–rich and gender differentials. There is an interplay of different demographic, educational, socioeconomic, biological and care-seeking factors, which are responsible for the differentials and the high burden of neonatal mortality. Addressing inequity in India is an important cross-cutting action that will reduce newborn mortality.