Neonatal Tumours, a rare subset of Paediatric oncology, encompass a heterogeneous group of abnormal cell growths that manifest within the first 28 days of life. This intricate and challenging medical landscape presents a complex amalgamation of benign and malignant neoplasms affecting various organ systems, including the central nervous system, kidneys, liver, and soft tissues. Neonatal Tumours often pose unique diagnostic and therapeutic dilemmas due to their distinct biological characteristics and the delicate nature of the developing neonatal organism. Histological diversity further complicates the clinical picture, ranging from teratomas and neuroblastomas to rare entities such as congenital mesoblastic nephroma and infantile fibrosarcoma. Early detection and precise diagnosis are critical for developing effective treatment strategies, yet the intricate balance between therapeutic efficacy and potential harm to the vulnerable neonate demands a multidisciplinary approach. Advances in imaging modalities, molecular diagnostics, and genetic profiling have augmented our understanding of neonatal Tumours, enabling tailored therapeutic interventions. However, the limited pool of clinical data and the scarcity of large-scale trials dedicated to neonates pose formidable challenges for evidence-based management. Collaborative efforts among Paediatric oncologists, neonatologists, surgeons, and geneticists are imperative to navigate this intricate terrain, fostering a comprehensive understanding of neonatal Tumours and advancing therapeutic modalities to improve outcomes for these youngest and most fragile patients. As the medical community strives to unravel the intricacies of neonatal Tumours, the pursuit of innovative therapies and a nuanced understanding of the intricate interplay between molecular biology and clinical manifestations remain pivotal in optimizing the care and prognosis of neonates facing these formidable challenges.