Background and Objective : Universal newborn hearing screening (UNHS) was started in the Hospital Universiti Sains Malaysia (HUSM) in January 2003. To comply with international standards, we determined the outcome of the newborn hearing screening program for the first 5 years of its implementation, from January 2003 to December 2007. Methods : The program screened all infants who were delivered in HUSM. In a retrospective review, the outcomes in terms of coverage, prevalence of hearing impairment, referral rate for each screening, age at detection of hearing impairment and at hearing aid-fitting were analyzed. Results : Ninety-eight percent of newborns were screened. The study included 16 100 randomly selected newborns. The initial screening referral rate was 25.5%. The prevalence of default for second and third screening was 33.9% and 40.7%, respectively. The mean (SD) age at detection of hearing impairment was 3.3 months (0.86). The mean (SD) age at fitting of a hearing aid was 13.6 (4.8) months.The prevalence of hearing impairment was 0.09%. Conclusion : A newborn hearing screening program is an important tool for early diagnosis and treatment. Even though the prevalence of hearing impairment may be low, the problem needs to be addressed early as the development of infants requires normal hearing.