Neonatal hypoglycemia remains a common and challenging metabolic disorder in the newborn population, with potential long-term neurological consequences if left untreated. This chapter provides a comprehensive overview of the current understanding, diagnosis, and management of neonatal hypoglycemia as well as the ways to prevent neonatal hypoglycemia. The transition from intrauterine to extrauterine life involves complex metabolic adaptations, with a physiological drop in blood glucose levels during the first hours of life, and while transient hypoglycemia is often benign, prolonged or severe hypoglycemia can lead to long-term adverse neurodevelopmental outcomes. Despite decades of research, a universally accepted definition of neonatal hypoglycemia remains elusive. Current guidelines suggest different thresholds based on postnatal age and clinical risk factors. As neonatal hypoglycemia may be asymptomatic, screening protocols target at-risk infants, including those born to diabetic mothers, those who are small or large for gestational age, and preterm neonates. Management strategies focus on maintaining euglycemia through early feeding, intravenous glucose administration, and in some cases, the use of oral dextrose gel. Persistent hypoglycemia may indicate underlying endocrine or metabolic disorders requiring further investigation and treatment. This chapter aims to equip the reader with an understanding of the physiological processes of glucose metabolism, as well as early recognition of pathological glucose metabolism and the approaches used to identify, treat, and prevent neonatal hypoglycemia.