This paper, the first in the Lancet Neonatal Survival series, focuses on the growing proportion of child deaths that occur in the neonatal period (the first four weeks of life), accounting for 38 per cent of all child deaths in 2000, or 4 million a year. While 99 per cent of neonatal deaths arise in low and middle income countries, research focuses on the one per cent of deaths in rich countries. The highest neonatal mortality rates are found in sub-Saharan Africa. The authors conclude that the Millennium Development Goal for child survival cannot be met without achieving substantial global reductions in neonatal mortality. They argue that inequity should be addressed as a priority.