Neonatology has rapidly grown over the past few years to its present status of a highly technologically driven specialty. Centres in resource restricted countries tend to adopt management guidelines from the developed world and integrate them into local practice. Although international neonatal practices have influenced neonatal care at the University Hospital of the West Indies (UHWI), over the past fifty years there has been local clinical research done at the hospital that has informed local practice. Causes of neonatal mortality have been documented and this has informed neonatal resuscitation practices, infection control policies and ventilatory support of premature infants. Changes in the incidence of various aetiologies of jaundice over the years have altered how jaundiced neonates are investigated and managed. Research on neonatal sepsis has informed antibiotic choices and treatment regimes. Studies on preterm infants have informed management polices on ensuring optimal thermal environment, on the timing of discharge and on neurodevelopmental follow-up. It is clear that clinical research at the UHWI has informed neonatal care at the institution over the past 50 years and it is hoped that it will continue to do so for the next 50 years and beyond.