Introduction: Birth asphyxia is one of the common causes of early neonatal mortality. Hypoxic-ischemic encephalopathy (HIE) leads to severe neurological deficits in neonates which can result in early neonatal deaths. MRI brain is the modality of the choice to look for various patterns of hypoxic ischemic injury. Materials and methods: Hospital based prospective study was done on 30 term and preterm infants/children with history of birth asphyxia and other neonatal, maternal and placental causative factors to look for MRI patterns of HIE. MRI Brain was used as screening modality to look for evidence of hypoxic ischemic injury (HIE). Results: The study demonstrated that term infants had significant involvement of subcortical and/or periventricular white matter and basal ganglia/thalamus region. While the preterm patients had predominant periventricular leucomalacia type of involvement. Conclusion: MRI of the brain is the ideal imaging modality of choice for the diagnosis and follow-up of infants/children suspected/diagnosed with hypoxic-ischemic encephalopathy (HIE). The pattern of brain injury depends on brain maturity at the time of hypoxic insult, duration and severity of insult.