A safe and effective neonatal building is an aspect of Neonatal Rescue Scheme (NRS) concept as described in the literature. Observable habitual practices leading to various neonatal outcomes at tropical LMIC settings point to adverse facility-based mortality contributions from poor nursery layouts. Sadly, the negative impacts of building deficiencies are not well-understood or empirically quantified as tailored to the limitations in resource-constrained tropical climate. Lack of helpful building features may exacerbate high morbidity owing to adverse issues such as poor infection control, evening fever syndrome (EFS), noise pollution, medication safety, intra-ward traffic, nursing fatigue, and parental services. A tropical LMIC setting has the disadvantages of relative poverty, infrastructural inadequacies, and adverse equatorial climatic conditions, necessitating design-specific requirements for safe neonatal care. This chapter is proposed to explore the constraints, concepts, and features as integrated in some NRS nurseries at different tropical regions of Nigeria, which function to mitigate the climate, poor infrastructure, and societal poverty against neonatal survival.