BACKGROUND The most readily available methods for testing serum total bilirubin in neonates are the capillary tube-directed optics color method and serum biochemistry. Because inconsistency between these two methods may cause confusion in clinical practice, this study was designed to quantify their differences. METHODS In 46 neonates with clinical jaundice, total bilirubin was measured by two different methods, using a nonchemical photometric device and a laboratory analyzer. RESULTS Differences in results between these two methods were statistically significant, especially when total bilirubin level exceeded 15 mg/dL. CONCLUSION Clinicians should be aware of the differences between the two methods when making decisions in patient care.