Background: Brain injury that occurs during the perinatal period is one of the most commonly recognized causes of severe long-term neurological deficits in children often referred to as cerebral palsy (CP) that affects approximately 2-3 per 1000 school-aged children. Objectives: The aim of this study was to detect the validity of urinary uric acid/creatinine ratio (UUA/Cr) in the identification of perinatal asphyxia and its role in grading asphyxia according to severity of hypoxic ischemic encephalopathy. Patients and methods: This prospective study was carried out at Neonatology Unit or delivered at Gynecology Department of Zagazig University Hospitals during the period from July 2020 to July 2021. The study included 48 newborns with hypoxic ischemic encephalopathy (HIE). They were divided into two groups each group included (24) patients. Group I included 24 babies with perinatal asphyxia. Group II included 24 healthy babies (with gestational ages and weights matched to cases) as control group. The primary outcome was determining the values of UUA/Cr in newborns with hypoxic ischemic encephalopathy and its relation with different stages of HIE. Results: UUA/Cr was significantly higher in cases as compared to control and was significantly higher in preterm babies when compared to full-term ones (this was applied for both cases and control). Moreover, significant difference in UA/Cr ratio in comparing the mild, moderate and severe groups of HIE. Conclusion: We found that UA/Cr ratio level was increased in the asphyxiated newborns in comparison to normal healthy newborns.