The proper registration of cases of deaths and their analysis contribute to give visibility to the real gaps and demands of health services. The monitoring and the analysis of the Infant Mortality Rate (IMR) and its characteristics are paramount for the development of health policies and interventions aimed at the promotion and protection of child health. Thus, we aimed to characterize neonatal deaths recorded in Palmas, Tocantins, Brazil, in the period from 1999 to 2018, according to sex, weight and age of newborns, maternal age, and municipality of occurrence. There were 800 deaths of children aged up to 27 days of life in the municipality of Palmas from 1999 to 2018, with a statistical difference in the proportion of neonatal deaths according to the occurrence of the event, gender, and weight, with a higher proportion of early neonatal deaths when their occurrence was in Palmas. Although the municipality of Palmas has recorded advances in infant mortality indicators, specifically in the neonatal component, considering that Brazil proposes to reduce newborn mortality to a maximum of five per thousand live births by 2030, advances will be necessary to qualify perinatal care in the region in order to avoid preventable infant deaths. Thus, an urgent demand is the improvement of prenatal and maternal-infant care services in the municipality in order to favor maternal and infant indicators.