Low birth weight (LBW) is the most important preventable cause in the neonatal period leading to very high neonatal mortality and morbidity in developing countries like Bangladesh. A cross sectional study was conducted in the neonatology ward, Mymensingh Medical College Hospital, Mymensingh from July 2014 to December 2014 to identify the risk factors and immediate hospital outcome of Very Low Birth Weight (VLBW) Appropriate for Gestational Age (AGA) babies in context of present neonatal hospital care standard. Total 100 preterm very low birth weight babies were enrolled and selected by weight, intra uterine growth chart and new ballad score. There is slight preponderance of male babies (64%) over female babies (36%). The overall survival and mortality rate was 50% and 50% respectively in the present study. Mortality is highest (76.47%) in babies whose gestational age 28 weeks and the mortality rate gradually decrease as gestational age increases. Correlation co-efficient (r) between gestational age and number of died is -0.85. It indicates highly opposite relation between the variables, p value (<0.069) which is strong opposite relation. Mortality is highest (66.66%) in babies whose birth weight below1100gm, in comparison to those whose birth weight above 1100gm and correlation co-efficient (CC) r = -0.433 (p<0.466) which is not significant. That means not only birth weight but also other factors are responsible for mortality of very low birth weight baby. Neonatal mortality bears inverse relationship with birth weight and gestational age. This emphasized the need for large scale study which will provide the guideline for appropriate measures to be taken to combat the situation.