 This study found that neonatal birth trauma was common in eastern Ethiopia with 16.9% of newborns experiencing some form of injury during delivery. Factors associated with increased risk included instrumental delivery, early preterm birth, macrosomia, fetal malpresentation, male gender, and facility-based delivery. These findings suggest that efforts should be made to promote health facilities-based delivery, prevent premature birth, make decisions about mode of delivery earlier, and minimize instrumental deliveries to reduce the incidence of neonatal birth trauma. This article was authored by Gedysa Tolosa, MSC, Nega Asepha PhD, Mollulam Kenney, MSC, and others.