Aims and objective: Body temperature of a neonate continues to be under-documented, under- recognized, and under-managed, even though studies have shown that neonatal hypothermia increases mortality and morbidity. We studied and analyzed temperature control (thermal chain) from point of referral to admission in NICU and overcome the pitfalls in management thorough serial PDSA (plan-do-study-act). Material and methods: Prospective observational analysis done over a period of 1 year. Study conducted in 3stages. In 1st stage protocol planned to record the temperature of all babies within 15min of admission. In the 2nd stage quality team formed and point of referral, mode of transport, and casuality stay were added. In 3rd stage management of temperature at casuality, referral point and in NICU was included. Results: In the 1st stage of study 93% adherence to protocol was seen and 58.6% of patient presented with moderate hypothermia and 24.1% patient having cold stress. As study progressed in 2nd stage, compliance increased to 96% but 73% cases were still not in the normal range of temp. Management of hypothermia was not done appropriately and 24% cases remain hypothermia on reaching NICU. Casuality stay was 69min. After subtle changes in infrastructure compliance increased to 100%, and time taken to note temperature was 2min. Average waiting time to casuality was decrease to 15min, and Normothermic cases coming through ambulance increased to 70%. Conclusion: This is live example which shows how a unit has built steps from basic change ideas of recording temperature to a comprehensive chain of ideas in maintaining thermal chain from the point a baby is received.