AbstractRecent epidemiologic data demonstrate that prenatal factors play a major role in the genesis of brain injury in childhood, e.g., cerebral palsy and mental retardation. Nevertheless, there is extensive experimental, clinical, and neuroimaging data that show that acute, intrapartum hypoxic‐ischemic insult is an important factor in the genesis of irreversible brain injury, especially in term newborns. The precise timing of onset of hypoxic‐ischemic cerebral injury in premature newborns may be more difficult to establish, and postnatal complications (e.g., intraventricular hemorrhage, posthemorrhagic hydrocephalus) undoubtedly play a major role. When the potential deleterious consequences of severe, intrapartum asphyxia are minimized, there is a risk that important opportunities for prevention of newborn cerebral injury may be missed. In this context, new techniques may permit rapid, in vivo delineation of the critical processes involved in newborn hypoxic‐ischemic brain injury that are key factors for the development of effective preventive and interventional strategies. MRDD Research Reviews 3:22–27, 1997. © 1997 Wiley