Very low birth weight preterm infants are at increased risk for neurodevelopmental impairment. In this prospective study we hypothesized that using a combination of neuroimaging (serial head ultrasounds), neurophysiologic measurement (amplitude integrated EEG), and clinical neurobehavioral examination (NICU Network Neurobehavioral Scale) can predict neurodevelopmental outcome of very low birth weight infants < 1500 grams. One hundred infants with gestational age of 27.9 ± 2.6 weeks and birth weight of 997 ± 299 gram admitted to the George Washington University Hospital were enrolled. Controlling for other confounders, early predictors of adverse short term outcomes (death or severe developmental delay at 4 months corrected age) were intubation in the delivery room, and grade III-IV intraventricular hemorrhage. The head ultrasound had poor sensitivity for predicting adverse outcome. Dysmature aEEG in the first 1 week of life increased the sensitivity of ultrasound in detecting adverse outcome from 27% to 58%. The NICU Network Neurobehavioral Scale could predict the mental development at 4 months corrected age. We conclude that amplitude integrated EEG and NICU Network Neurobehavioral Scale at term are feasible tools that can be used to predict the outcome of very low birth weight infants.