Despite the major advances in obstetric and neonatal care, hypoxic-ischemic cerebral injury during the perinatal period is still a significant cause of death and severe long term neurological impairment. The main mechanism of pathogenesis underlying most of the neuropathology attributed in hypoxia-ischemia is impaired cerebral blood flow. Therefore, the aim of this study was to detect the early changes in cerebral blood flow of hypoxic patients and its relation to their prognosis. This case control study included 25 hypoxic neonates with low Apgar scores at 1 and 5 minutes during the period from April 2013 till January 2014 and compared to 20 age and sex matched controls. Maternal and obstetric history was taken from their mothers to detect antepartum and intrapartum risk factors. The most commonly attributed intrapartum risk factor in our cases meconium aspiration.