<p>Early neonatal mortality (ENM), defined as the death of a newborn within the first seven days of life, remains a major public health challenge in fragile and low-resource settings such as Somalia. Decades of conflict, weak health systems, and limited access to maternal and newborn healthcare services continue to threaten neonatal survival. This study examined the determinants and spatial distribution of early neonatal mortality in Somalia using nationally representative survey data. This study used data from the 2020 Somalia Demographic and Health Survey (SDHS). After data cleaning and eligibility screening, 15,713 unweighted live births were included in the analysis. Sampling weights (V005) were applied to account for the complex survey design, resulting in a weighted sample of 15,720 live births and nationally representative estimates. Descriptive statistics summarized participant characteristics and estimated ENM prevalence. Multilevel mixed-effects logistic regression identified individual-, household-, and community-level determinants of early neonatal mortality. Spatial analysis and data visualization were conducted in R version 4.3.2, using Global Moran’s I, Local Moran’s I, and Getis-Ord Gi* statistics to assess geographic variation. The weighted prevalence of early neonatal mortality was 2.5%, equivalent to approximately 25 deaths per 1,000 live births. Multiple births were associated with significantly higher odds of early neonatal mortality compared with singleton births (AOR = 4.34, 95% CI: 2.64–7.13). Female neonates had lower odds of mortality than male neonates (AOR = 0.66, 95% CI: 0.54–0.81). Higher birth order was associated with increased mortality risk (birth order 3: AOR = 1.54, 95% CI: 1.09–2.18; birth order 4+: AOR = 1.88, 95% CI: 1.22–2.91). Significant regional disparities were observed, with the Bay region showing higher odds of mortality. Spatial analysis revealed geographic variation in mortality burden across Somalia. Although Global Moran’s I showed weak positive spatial autocorrelation (I = 0.1668), the result was not statistically significant (<i>p</i> = 0.0938). Higher mortality burdens were observed in Bay, Bakool, Awdal, and Lower Juba, while Gedo emerged as a statistically significant cold spot. Early neonatal mortality remains high in Somalia and is influenced by both individual-level and regional factors. Although nationwide spatial clustering was not statistically significant, important geographic disparities exist. Targeted maternal and newborn health interventions are needed, particularly for high-risk births and regions with elevated mortality burdens, to accelerate progress toward achieving Sustainable Development Goal 3.</p>