Background: Hypoxic ischemic encephalopathy (HIE) refers to the CNS dysfunction associated with Perinatal Asphyxia (PA) which is an important causes of permanent damage to CNS tissue. MRI imaging methods attributes to better understanding of pathological events and disease progression that may provide decision regarding intervention. MRI has a higher sensitivity and is extremely valuable in assessing the extent of hypoxic-ischemic brain damage during the early postnatal period and later infancy. It is also more specific which clearly differentiates fluid filled cavities, oedema, gliosis and hemorrhage. On this background this study was undertaken to evaluate the MRI changes of all grades of HIE patients. They were also followed up at different time intervals for upto 1 year to correlate the MRI changes and neurodevelopmental outcome