Background: The incidence of hypoxic-ischemic encephalopathy is reportedly high in countries with limited resources. It is one of the top 20 leading causes of burden of disease in all age groups and is the fifth largest cause of death of children younger than 5 years (8%). Although data are limited, birth asphyxia is estimated to account for 920,000 neonatal deaths every year and is associated with another 1.1 million intrapartum stillbirths. Objective: To study EEG and neuro imaging profile of newborns with Hypoxic Ischemic Encephalopathy (HIE). Methods: 34 neonates comprising of inborn and outborns, admitted in NICU, Gandhi Hospital, Secundarabad with features of Hypoxic Ischemic Encephalopathy according to Sarnat & Sarnat staging clinically were subjected to cross sectional study. All cases were subjected to neurosonogram, EEG and MRI. Analysis of data was done by SPSS. Results: 61.8 % were males and 38.2 % were females. 79.4% were born by vaginal deliveries and 20.6% were LSCS. 70.6% were HIE stage I, 20.6% stage II and 8.8% were HIE stage III. HIE stages were neither influenced by out-born / in-born groups (P > 0.05), nor by mode of delivery. (P > 0.05). There was highly significant association between EEG and Stage of HIE. (P = 0.000), between abnormal neurosonogram findings and Stage of HIE (P = 0.002), between MRI Brain abnormalities and increasing stages of HIE (P = 0.061). Conclusion: Early neuroimaging by neurosonogram is helpful in screening neonatal stroke and looking for other abnormal findings. MRI brain done later can miss transient abnormalities like very small haemorrhages and cerebral edema, which may resolve. Therefore, sequential neuro imaging may be more helpful. Neonatal stroke is probably under-recognized, and may be better picked up by neuro-imaging especially MRI of the brain.