Encephalopathy from hypoxic-ischemic injury is a major cause of morbidity and mortality in term infants. MRI is the gold standard in evaluating the nature and extent of injury. Although imaging this population is challenging, important information can be obtained safely. Patterns of injury and the likely mechanisms that cause them are reviewed. Conventional images combined with additional techniques provide clues to cause, timing, and long-term prognosis. As altering acute neurologic damage with interventions in the acute period becomes a reality, MRI will play a crucial role in delineating which infants have the most to gain and act as a biomarker to gauge response.