Purpose: To report the causes and patterns of mortality among infants admitted to our NICU over 13-year period. Moreover, we analyzed the trends regarding mode of en-of-life care provided. Materials and Methods: All neonates who died at the Soonchunhyang university bucheon hospital that occurred between January 1, 2002 and December 31, 2014 were identified. The causes and circumstatnces of death were abstracted from the individual medical record retrospectively. Trends of mortality were compared between 2 time period: 2002-2007 versus 2008-2014. Results: Of 5,223 admissions in our NICU, 97 neonates died. The overall mortality rate was 1.9%. The most common cause of death was sepsis (15%). At lower gestational age, preterm infants died by extremely prematurity and complications of premature birth such as pulmonary hemorrhage, sepsis, intravascular hemorrhage or NEC. Among term infants, the principal cause of death shifted to hypoxic ischemic encephalopathy and asphyxia. Sixty three infants (64.9%) received maximal intensive care; 34 infants (35%) had redirection of intensive care. Over the period, the proportion of infants for whom there was a decision to forgo life sustaining care before death was increased from 30.6% to 39.6%. Infants who died after redirection of care had significantly lower gestational age and smaller weight at birth (30.5 vs 27.1 weeks, p= 0.005, 1528 vs 1063 gram, p= 0.025). Conclusion: The mortality of very low birth weight infants (VLBWIs) was decreased over two time period but consistent in overall mortality. Infection remain important cause of death especially for preterm infants. In our uint, redirection of care as the circumstances of death was increasing, suggesting that quality-of-life should be considered as an important factor in the decision-making process for infant, parents and medical staffs.