• Many term newborns suffer some degree of perinatal asphyxia, but few become permanently brain damaged as a consequence. The newborns at risk for major neurologic handicaps have evidence of derangement in many organs, depressed cerebral function at birth that continues for days or weeks, and in many cases, convulsions soon after birth. The pathophysiologic mechanism of brain damage in hypoxic-ischemic encephalopathy remains contested, and no specific therapy is clearly beneficial. The immediate treatment of the asphyxiated term newborn requires attention to the derangements in multiple organ systems and the use of anticonvulsants when indicated.