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The causes of neonatal conjunctivitis have characteristic onset windows: chemical irritation typically occurs within 24 hours, gonococcal infection at 2–5 days, chlamydial infection at 5–14 days, and HSV at 6–14 days; other bacteria may occur at any time. Clinical clues help distinguish them. Gonococcal disease can progress rapidly to corneal ulceration and is an emergency, while chlamydial infection may coexist with pneumonia and HSV can involve periocular vesicles or spread systemically. Assessment may include conjunctival sampling, culture, nucleic acid testing, and HSV PCR when indicated. Prevention, cause-directed treatment, infection control, and prompt follow-up are central to care.