Sepsis may be defined as a systemic illness caused by microbial invasion of normally sterile parts of the body, inducing a systemic inflammatory response. Such systemic infection occurring in infants within 28 days of life is referred to as “neonatal sepsis”. Actually, a consensus over a definite clinical or semiological definition of neonatal sepsis remains controversial. This is partly due to questions of semantics and classification, with a problem of age delimitation, responsible for misuses of the “neonatal sepsis diagnosis”. More so, the limitation of neonatal sepsis to bacterial etiology due to its severity has led to an increasing misunderstanding of sepsis, to the detriment of other causative agents such as viruses, fungi, protozoans and mycoplasma. These controversies are further amplified by the diversity of the literature available on the subject, the plurality of language concepts and translation bias. Physicians worldwide may therefore be faced with diagnostic and semantic challenges as far as infections in neonates and slightly beyond the neonatal period are concerned. This indicates a necessity for the re-questioning of past concepts for clarity, or reconsideration if need be. In this paper, we did a succinct review of neonatal sepsis and its highlights, exposing controversies while proposing some adjustments to consider.