Abstract: Intracranial hemorrhage (ICH) in neonates is an acquired lesion with enormous potential impact on morbidity , mortality , and long-term neurodevelopmental outcome.this study was done to study the prevalence of ICH in preterm neonates without any neurological signs detected and to determine the different obstetric and neonatal risk factors associated with the development of ICH .Case – control study throughout the period from June 2011 to December 2011 .This study was conducted on 58 preterm neonates who were admitted to Neonatal Intensive Care Unit (NICU) of Obstetrics and Gynecology Hospital , Ain Shames University. Detailed history taking: maternal, obstetric and delivery circumstances laying stress on maternal and obstetric risk factors of ICH. Assessment of the general condition using APGAR score at 1and 5 minutes. Assessment of gestational age (GA) using Ballard score. Assessment of birth weight, thorough clinical examination laying stress on neurological examination according to Sarnat. Imaging studies using cranial ultrasound (CUS) on 3rd days of life. The prevalence of asymptomatic cases with ICH was 60.7 %. There are certain maternal and neonatal risk factors that are associated with increased risk of ICH. CUS can be considered as a specific and sensitive indicator for occurrence of ICH