Abstract: The early neonatal outcome of vaginal breech delivery is an important to determine which way the breech presentation should be dealt with. This will help counseling the pregnant women with breech about the possible early adverse outcome that associated with vaginal breech delivery. This study was done to determine the Early Neonatal Outcome. of breech presentation delivered vaginally at El Sheikh Fadul maternity. This was a descriptive cross sectional hospital based study of vaginal breech deliveries, done from February to August 2015, using a time frame of vaginal breech births of babies alive. Data collection was by a well-designed questionnaire. There were 2812 deliveries during the study period with only 90 patients with vaginal breech deliveries representing 3.2%. Eighty-three women with breech presentation (92.2%) had attended antenatal clinic. Only 58% (52 women) of women had emergency intrapartum ultrasound scans. Thirty-seven babies (41.1%) had respiratory distress, neonatal encephalopathy was present in 19 babies (21.3%), three babies (3.3%) had significant physical injuries. Two babies had lacerations on anus secondary to vaginal examinations and one baby had a fractured clavicle. Neonates discharged from nursery were 91, and there were 8 perinatal deaths. The median birth weight of the newborns was 2370 g with a range of 800 g to 3920 g. There were 8 newborns with a birth weight less than 1000 g. The calculated incidence of perinatal death of the study period was 0.3%. A small percentage (2%) of poor neonatal outcomes occurred subsequent to vaginal breech delivery, with small risk of perinatal morbidity and mortality. low 5-min, Apgar scores, and admission to the neonatal care unit found to be higher in patients who have no antenatal care. However, the majority of undiagnosed breech was delivered vaginally without significant morbidity or mortality.