The incidence of hypoxic-ischemic encephalopathy (HIE) is not well known, however, the common causes of hypoxic-ischemic encephalopathy are sudden cardiac arrest, acute respiratory failure and carbon monoxide poisoning. Due to high metabolic demand, the brain is very susceptible to damage from deprivation of blood supply and oxygen delivery. When patients recover from comatose after HIE, there are various spectrums of neurological outcomes, ranging from vegetative state to good recovery. Various methods including neurologic examination, neurophysiologic and biochemical tools, neuroimaging technique have been proposed for the prognostic evaluation of HIE. This article reviews the pathophysiology of HIE and predictive methods for neurological recovery after HIE.