Newborn screening is a major aspect of public health success. Babies in every state are tested for a recommended uniform screening panel of conditions not otherwise immediately evident in the first days of life. With the goal of reducing morbidity and mortality, conditions should be added to newborn screening panels using a scientific, evidence-based process. Newborn screening is a system involving partners at many levels; neonatologists have a special role in ensuring that their vulnerable patients also receive this life-saving test. Careful attention to the social, legal, and ethical aspects will help increase the scope of newborn screening.