The purpose of this research work was to quantify referrals and transport delays to the NICU of a private tertiary care hospital and to examine the factors responsible for the delay. A qualitative descriptive pattern, with a purposive sampling was used for the study. Out of 33 referrals made at a NICU of a tertiary care hospital in Karachi, Pakistan, 27 parents were interviewed. Semi-structured interviews were carried out using open ended questions along with a demographic questionnaire. The findings of the work revealed that factors causing delay in transport of sick neonate to NICU included delay in decision making, absence of male family member, financial expenditure, and unavailability of beds at tertiary care hospitals. A large number of referrals were made to tertiary care NICU however, only few got admitted. There is a need to introduce a structured sheet to track all these referrals and take measures to speed up the transport process, and strengthen health programs and policies of the country. The activity was a huge quality improvement initiative taken by the team.