Bharadwaj S, et al. - In order to eliminate health care facility-onset methicillin-resistant Staphylococcus aureus (HO-MRSA) transmission among all neonatal unit admissions and improve hand hygiene (HH) and environmental hygiene compliance to 100%, a quality improvement project was undertaken in a tertiary care neonatal unit over a 9-month period, with sustainability data being monitored. In this project, critical analysis of existing inpatient admission processes, staff HH, and environmental hygiene practices was done. They implemented sequential interventions, like the reinforcement staff awareness on infection control practices via regular education and updates, offering “just in time” feedback, ensuring easy availability of cleaning equipment, individualizing items for all patients, keeping personal belongings away from clinical areas, and revising admission work flow for ex-utero transferred babies from other hospitals. As per outcomes, they successfully had zero MRSA transmissions to previously noninfected and noncolonized patients over the 9-month period in the neonatal unit; from a preintervention median of 87.1% and 82.2%, HH and environmental hygiene compliance, respectively, both reached 100%, which has been maintained. Elimination of MRSA transmission in the neonatal unit can be achieved via intensive reinforcement of infection control practices, strict cohorting of ex-utero transfers, universal surveillance on admission, and improvement in HH and environmental hygiene compliance.