The global burden of neonatal deaths is around 37% of all under-five deaths (UNICEF 2008). In Bangladesh, neonatal deaths account for almost half of all under-five mortality. Most newborn deaths in Bangladesh take place at home and in the absence of a skilled hand. The target of Millennium Development Goal 4 for Bangladesh is to reduce under-five mortality by two thirds by 2015 from 1990 levels. The objectives of this article are to give an overview of newborn health in Bangladesh and provide a strategy for further reducing under-five mortality to achieve MDG 4. Data for this study were obtained from the Bangladesh Demographic and Health Survey (BDHS) 2004 data set (National Institute of Population and Training [NIPORT] et al. 2005). According to the BDHS, under-five mortality in Bangladesh declined from 133 per 1000 live births in 1991 to 88 per 1000 in 2001, about 4.1% per year. However, the decline was faster between 1991 and 1997 than from 1997 to 2001. The BDHS shows that while neonatal deaths were 39% of all under-five deaths in 1991, they constituted almost half in 2001. The highest concentration of newborn deaths occurred during delivery and within the first 24 hours of birth. Reducing newborn deaths will be an important strategy to achieve MDG 4.