Perinatal asphyxia is a significant cause of mortality in newborns. Some newborns develop cerebral injury and hypoxic ischemic encephalopathy as a consequence of serious asphyctic episode. There is a variety of consequences of hypoxic ischemic encephalopathy such as mild neurological sequels, cerebral palsy, severe cognitive and psychomotor developmental delay and death. Until recently, the therapy of hypoxic ischemic encephalopathy was only supportive. In the last twenty years, physicians started to use therapeutic hypothermia in asphyxiated newborns. The use of therapeutic hypothermia has its basis in neuroprotective effect and stopping the progression of neuronal injury. Hypothermia must be initiated in the latent phase of cerebral injury, which means in the first 6 hours from birth and acute asphyctic trauma. A good selection of newborns for the therapeutic hypothermia is quite challenging. Eligibility criteria for cooling are gestational age above 36 weeks, initiation of hypothermia in 6 hours after the birth, evidence of peripartal hypoxia-ischemia and diagnosis of moderately severe or severe encephalopathy. The optional criterion of eligibility is an abnormal result of amplitude-integrated electroencephalography. There are two cooling methods for newborns- whole body cooling and selective head cooling with mild systemic hypothermia. Target body temperature is 33.5°C in the first and 34.5°C in the second cooling method. The cooling of a newborn continues throughout 72 hours with a strict regulation of body temperature and monitoring of vital functions and a control of other significant parameters. Additional caution is needed in the administration of drugs because hypothermia changes pharmacodynamics and pharmacokinetics of certain drugs. The adverse effects of the hypothermia at these body temperatures are not severe and they are acceptable for a potential benefit. The neurological assessment of children 18 months after the therapeutic hypothermia has shown significant reduction in mortality and severe neurodevelopmental damage.