Abstract. Objective: To evaluate Staphylococcus aureus surveillance, prophylaxis, and decolonization practices among US NICUs. Study design: An email survey was sent to NICU directors in the Perinatal Section of the American Academy of Pediatrics. Results: 682 directors were surveyed and 250 (37%) responded. Eighty-three percent perform S. aureus surveillance (70% by culture; 30% by PCR). Of these, 42% perform routine admission screening whereas 12% screen only during an outbreak. Nine percent utilize routine prophylaxis, most commonly chlorhexidine gluconate (36%), triple dye (36%), mupirocin (27%), and hexachlorophene (9%). Prophylaxis is typically short-term with only one unit using mupirocin throughout hospitalization. Thirty-nine percent of NICUs attempt decolonization. Conclusion: This study shows widespread use of routine S. aureus surveillance with a minority of NICUs performing prophylaxis or decolonization including atypical strategies. By understanding what preventive strategies are utilized in the neonatal medical community, NICUs may be able to seek out strategies that support their local epidemiology.