Neonatal hyperbilirubinemia is a frequently encountered problem in the neonatal period and carries a potential risk of encephalopathy. Early detection and quantification is important, and transcutaneous bilirubinometry (TcB) has been recommended as a non-invasive method for rapid screening. We prospectively compared the efficacy of TcB in 65 normal Pakistani jaundiced newborns undergoing simultaneous serum bilirubin measurements. Although the correlation between the two methods was significant (r = 0.66, P less than 0.01), the scatter was wide and the specificity only 53%. Although the technique offers the potential for non-invasive early screening of neonatal hyperbilirubinemia, it requires further validation in a larger study in our population.