Background: Perinatal asphyxia is a serious clinical problem and commonest cause of neonatal mortality and morbidity worldwide. It has a much higher burden in developing countries, particularly in Ethiopia. However, the short term outcome of perinatal asphyxia and predictors of survival are not well studied in neonates with perinatal asphyxia admitted to Hawassa compressive specialized hospital. Objective: This study aims to assess the short term outcome of perinatal asphyxia and predictors of survival among asphyxiated neonates admitted to the neonatal intensive care unit (NICU) of Hawassa Comprehensive Specialized Hospital from April 2020 to March 2022. Methods: A retrospective hospital-based cross-sectional study was conducted from June 2022 to September 2022. A simple random sampling techniques by lottery method was used to enroll a total of 151 study subjects. Data were collected by trained data collectors using a structured questionnaire and the data were cleaned, entered, processed, and analyzed using SPSS version 25; logistic regression analysis was done to assess short term outcome of perinatal asphyxia and predictors of survival among asphyxiated newborns. Statistical significance was declared at p <0.05, and adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to present the estimates of the strength of the association. The findings were summarized using a table and narratives. Result: One hundred fifty one asphyxiated newborn charts were assessed. The overall mortality rate of perinatal asphyxia in this study was 31.8%. Stage III perinatal asphyxia [AOR=0.028; (95% CI:0.005–0.139)] and acute kidney injury [AOR=0.045; (95% CI:0.006- 0.324)] were independent predictors of outcome of perinatal asphyxia. Conclusion and recommendations: Mortality of perinatal asphyxia was relatively high. Severe degree of asphyxia and acute kidney injury are highly associated predictors of mortality of perinatal asphyxia. Early detection and intervention of high-risk mothers during labor and delivery should be carried out by health care providers. Researchers should conduct further prospective studies with larger sample size.