Background: Neonatal illness severity scores are used to predict mortality and morbidity. As there has been significant development of neonatal care and understanding of the impact of prenatal factors in recent decades, there is a need to develop a new neonatal illness severity score. Objectives: Develop and validate a new neonatal scoring system based on prenatal risk factors and immediate care and compare its effectiveness with the CRIB score. Patients and methods: Data were retrospectively analyzed on 252 VLBW neonates in the development cohort treated from 2014. to 2016. and 100 VLBW neonates in the validation cohort, treated from 2017 to 2018. The ability of a new score to discriminate for mortality, BPD, neurological impairment, and ROP was investigated. In addition to descriptive methods, regression analysis was used to determine the factors affecting individual outcomes, and ROC analysis examined which value best distinguished the compared groups. Results: The overall mortality rate is 26.8%. 20.62% of infants had moderate and severe BPD. The incidence of neurological impairment is 21.1%. The new score has a better ability to discriminate mortality relative to birth weight, pregnancy age and AS at 5 ', and is eqiuvalent for prediction od mortality when compared to the CRIB score. Regarding prediction of neurological impairment, the new score is superior to the CRIB score. Conclusion: New neonatal illness severity score may equally predict mortality relative to the CRIB score and better predict the incidence of neurological impairment.