The aim of the study was to determine the prevalence of neonatal hypothermia and associated risk factors. A cross sectional, descriptive study of neonatal hypothermia was performed on 300 newborns consecutively recruited day and night during 2 months at a Ugandan periurban hospital. Parallel tympanic and rectal temperature measurements were made at 10, 30, 60, and 90 min post partum. Rectal temperatures taken at 10, 30, 60, and 90 min showed that 29, 82, 83, and 79 per cent of the newborns, respectively, were hypothermic. Newborns observed to have no body contact with the mother comprised 87 per cent of hypothermic newborns, whereas this was the case in 75 per cent of non-hypothermic newborns (p = 0.03). The mean birthweight was 3218 g. Low birthweight newborns constituted 9/86 (10 per cent) among hypothermic newborns, whereas this was the case in 9/209 (4 per cent) among non-hypothermic newborns at 10 min (p = 0.08). Adolescent mothers were encountered more often among mothers with neonatal hypothermia of the newborn than among non-hypothermic newborns (p = 0.025). Parity, preterm delivery, daytime or night time delivery, rupture of membranes >24 h and location of newborns in theatre, labour ward, or nursery did not differ when hypothermic and non-hypothermic newborns were compared. A persistent pattern of high prevalence of neonatal hypothermia was confirmed and indicates that more vigorous efforts have to be undertaken, also in a tropical setting, to overcome problems of non-adherence to appropriate methods for thermo-protection of the newborn.