Aim: To investigate the incidence and variations of mortality and morbidity in Pakistani preterm newborns. Methods: The study was conducted in Jinnah Postgraduate Medical Centre, Karachi during April 2020 and May 2021, this cohort studies research comprised children born at 36 weeks’ gestation in addition referred to 27 NICUs between 8 days of delivery. Infants have been monitored until they died or were discharged from the NICU. The main result was a combination of death or any serious illness (retinopathy of immaturity, and bronchopulmonary dysplasia) in babies who got full medical treatment after receiving medical advice. The main endpoints were the percentage of patients who were discharged against the medical recommendation, death, and particular comorbidities. Results: 7,856 (86%) of the 9,016 neonates got comprehensive treatment, whereas 2,214 (18%) have been released contrary to medical recommendations. The fiberglass actual result rate among many newborns who obtained appropriate treatment was 28% (3,838/8,859), maternal death 5% (255/7,856), sepsis 15% (992/7,856), necrotizing enterocolitis 4% (192/7,553), intraventricular hemorrhage/periventricular leukomalacia 8% (425/7,309), retinopathy of prematurity 3% (68/4,352), and bronchopulmonary dysplasia for any and all results, there were substantial differences across NICUs. Conclusion: In Pakistan, death and morbidity rates for premature newborns at 32 weeks of gestation are high, despite considerable differences amongst NICUs.