Neonates undergoing cardiac surgery are at high risk of postoperative mortality.It is necessary to identify clinical factors that are indicative of in-hospital mortality.The study investigated the predictive value of inotropic score(IS)and vasoactive-inotropic score(VIS)for mortality in neonates after complex cardiac sur-gery.Methods This was a retrospective analysis of the 214 neonates who underwent complex cardiac surgery for congenital heart disease at a tertiary pediatric cardiac surgery intensive care unit from January 2015 to Novem-ber 2017.Multiple demographics,intraoperative and postoperative variables were recorded.Multivariate logistic regression and the receiver operating characteristic(ROC)curve were performed to evaluate the relationship be-tween IS/VIS and in-hospital mortality.Results The neonates were divided into two groups according to mortal-ity.Neonates in the non-surviving group(n=16)had higher IS and VIS than those in surviving group(n=198).On multivariable regression analysis,after adjustment for potential confounders,IS but not VIS remained a strong predictor of in-hospital mortality,[initial IS:odds ratio(per 5-score increase):1.68,95％confidence interval:1.16-2.44,P=0.007;maximum IS:odds ratio(per 5-score increase):1.62,95％confidence interval:1.10-2.37,P=0.014].Conclusions In newborns with congenital heart disease,IS but not VIS within 24 hours is helpful for prediction of mortality at the early postoperative period after neonatal complex cardiac surgery.