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Abstract Economic Evaluation of Healthcare services is an emerging discipline that aims at efficient use of resources especially when it is scarce. Economic evaluation is crucial for proper management of healthcare facilities and policy making. Cost Analysis plays a pivotal role in different types of economic evaluation. Despite the importance of such studies, there are few economic evaluation studies available in Egypt especially those tackling healthcare cost analysis. The NICU in Obstetrics and Gynecology university hospital of Kasr Alainy, Cairo University is a well established unit that contains 57 beds, which represents about 40% or more of Cairo university hospitals’ neonatal intensive care unit (NICU) beds. Cost & expenditure analysis of this important center for neonatal care in Egypt will help in maximizing the care provided by the unit through regulating the expenditures .Such study may be a step forward to generate more economic evaluation studies in Egypt that pave the way to achieve Universal health coverage.This cost analysis study was done from the prospective of the unit administration as the provider of the service. The study design was an illustrative cost calculation and cost analysis example to calculate the total unit expenditure and actual costs for April cohort. The costs were classified into operating and capital costs. The prices were obtained from different sources according to the availability.The study addressed each cost item and we could calculate them in addition to calculations of the median survival of April’s cohort and it was found to be 29 days with no significant difference in survival between infants less than 32 week of gestational age and above 32 weeks of gestational age |