Background; Over one million newborns die every year in sub Saharan Africa alone, Half of these deaths occur in the first day of life, the first day is the tie of highest risk for both mother and baby. Tanzania’s newborn deaths each year at least 51,000 newborns die. Up to two-thirds newborns lives could be saved if essential care reached mothers and babies, post-natal care coverage in Tanzania is low and question remain on the quality and effectiveness of provided services and ability to prevent, diagnose and treat complications arising in post-natal period There is limited published information on the care newborn receiving during this critical time. Objectives: To assess the standard of immediate post-natal care services for the newborns within the first 24 hours after delivery at St. Joseph hospital in Moshi municipal, northern Tanzania. Methods; This was the cross sectional hospital based study conducted in June 2016 at St. joseph hospital Moshi municipal, this facility was selected purposely because it has high number of deliveries and easily accessible. All newborns born at St. Joseph hospital during the time of data collection and met inclusion criteria were invited to participate in the study through the concert of their parents. An exit interviews with 24 post-delivery women were conducted to obtain key information using questionnaires while direct observations was used to assess the availability of key instruments and supplies using a checklist. Results: The rate of counseling on optimal breastfeeding practice was higher in this study. Many women (83.2%) reported to deliver within 24 hour at St. Joseph hospital. On assessing wellbeing and detection of neonatal birth asphyxia, only 3.7% neonates were found to have birth asphyxia which was low and majority of neonates 71% cried immediately after delivery signifying good wellbeing to neonates. Among 107 women, only 35 (32.7%) women were adviced by skilled birth attendant on cord care after birth which is very low and 28% were taught about cord hygiene, to avoid water contact and use of spirit to disinfect while 68% had no idea. x Conclusion: There is improvement on neonatal health care services due to various efforts from the government and united nation via ministry of health and WHO respectively by introduction of best guidelines to be used by service providers to deliver post-natal care services. Awareness and demand creation activities are required in this setting to encourage women to attend frequently for hospital delivery cared by skilled attendants since these factors improved standard of immediate post-natal care services for their neonates.