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Background. Limited knowledge on the proportion of admission hypothermia and factors of death in hypothermic preterm neonates is hindering early and appropriate interventions in Ethiopia. Thus, studies on the proportion of admission hypothermia and factors of death in hypothermic preterm neonates are critical to enhancing preterm infants’ survival. Methods. Hospital-based cross-sectional study was conducted on 398 participants using the systematic sampling method from October 10, 2021, to December 15, 2022. A pretested data extraction tool was used to collect data. EpiData version 4.6 and STATA version 16 were used for data entry and analysis. Multivariable logistic regression analysis evaluated the association between independent and outcome variables with a 95% confidence interval (CI). Hosmer and Lemeshow test and variance inflation factor were assessed to check model fitness and collinearity, respectively. Pvalue<0.05 was considered statistically significant. Result. Of the 398 admitted preterm neonates, 331(83.2%) had hypothermia at admission. Factors that were significantly associated with mortality included outborn babies [Adjusted hazard ratio AOR=2.18:95% CI (1.03-4.62)], GA less than 32 weeks [AOR=6.64:95% CI (1.87-13.58)], weight less than 1500 gram [AOR=7.91:95% CI (1.21-15.38)], thrombocytopenia [AOR=3.36:95% CI (1.49-7.58)], and kangaroo mother care [AOR=0.38:95% CI (0.16-0.88)]. Conclusion. The proportion of admission hypothermia was high. Outborn babies, birth weight less than 1500 gram, gestational age<32 weeks, being thrombocytopenic, and lack of kangaroo mother care were identified as risk factors for hypothermic preterm neonatal mortality. Preterm labor prevention, improved inborn delivery, and kangaroo mother care may alleviate the high proportion of admission hypothermia and related mortalities in preterm neonates.