Background: Hypoxic ischemic encephalopathy in neonates is one of the common causes of morbidity and mortality. The clinical presentation and imaging findings are the corner stone in the diagnosis and determination of the severity of NE. Objectives: Our study was planned to test the function of MRI and TCUS in the early recognition of neonatal HIE cerebral injuries. Patients and methods: Our study registered 50 newborns presented with HIE manifestations. Brain MRI and TCUS were performed for each case and the results were compared. Results: MRI findings were positive in 37 cases. The diagnostic accuracy of TCUS was 72 % while of MRI was 88%. The sensitivity of MRI was 78.9% and specificity was 81.8%. The sensitivity of TCUS was 70 % and the specificity was 60%. Conclusion: TCUS is an efficient screening method in early detection of the etiology of NE in suspected cases; in seriously ill neonates it is sometimes important; however, early MRI is obligatory as it can detect precisely the degree of brain injury compared with TCUS alone.