Antimicrobial stewardship is the establishment of a practice to reduce and eliminate the inappropriate usage of antimicrobial medications. Antimicrobials can be a lifesaving intervention when used appropriately. However, antimicrobial misuse can cause a number of adverse effects to an individual patient and poses a broad threat to public health. When antibiotics are prescribed, they should be as narrow of spectrum and short of duration as possible while still maintaining their efficacy. Judicious use of antibiotics will limit antibiotic resistance and other adverse events. Implementation of a successful antimicrobial stewardship program (ASP) is key to preserving antimicrobials and improving neonatal outcomes.