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Surrogacy involves a woman (surrogate) who consents to carry a pregnancy on behalf of an individual or a couple who cannot conceive for medical reasons. Surrogacy is gaining popularity in Nigeria among infertile couples, partly because surrogacy provides an easier means to having children than adoption. Surrogacy can be either gestational or traditional. Though surrogacy gives hope to infertile individuals, it also comes with peculiar challenges that affect the newborn with medical, ethical, and legal dimensions that caregivers need to be aware of. We present three sets of preterm triplets conceived by Invitro fertilization (IVF), carried by gestational surrogacy, and managed in our facility. This case report highlights challenges encountered while managing these neonates to create awareness and suggest solutions and guidance to neonatal practitioners. Topmost challenges include the unsustainability of feeding with the mother's own milk, lack of kangaroo mother care, abandonment of care by commissioning parents, delay in getting consent for treatment/procedures, determining the legal status of the child vis-à-vis simple issues such as changing the name of the child from that of the surrogate to that of the commissioning parents. The hospital's legal and welfare departments were key resource units and were involved early in managing these neonates. One baby from each set of triplets was successfully discharged home to the commissioning parents. In conclusion, surrogacy is becoming increasingly common as a means of becoming parents for infertile individuals. There is an urgent need for proper regulation and legal framework for surrogacy and assisted reproduction in Nigeria., (Copyright © 2024 Nigerian Medical Association.)