OBJECTIVE: To explore the value of electroencephalogram (EEG) in early diagnosis of brain injury in neonates with asphyxia.METHODS: EEG examination was performed in 49 neonates with asphyxia (mild: n=9; severe: n=40) within 6 hrs of their births. Of the 49 asphyxiated neonates, 33 had concurrent HIE, including 20 cases of mild, 9 cases of moderate and 4 cases of severe HIE. RESULTS: Twenty-one (63.6%) out of the 33 patients with HIE showed abnormal EEG, but only one (6.3%) in the asphyxia group without HIE. All of 13 patients with moderate-severe HIE showed abnormal EEG. The degree of EEG abnormality in neonates with HIE was consistent with the clinical grading of HIE. The neonates whose EEG showed electrical silence and burst suppression and the abnormalities were kept unrecoverable for more than 2 weeks had very poor prognosis.CONCLUSIONS: EEG can reflect brain injury caused by neonatal asphyxia and the severity of brain injury. It may be useful for early diagnosis of brain injury following asphyxia in neonates.