Neonatal neurosonography is used commonly to evaluate the central nervous system in the neonatal intensive care setting. The procedure can be performed at the bedside in these critically ill patients who may suffer from hemodynamic and thermoregulatory instability and often require mechanical ventilation. This article reviews current recommendations regarding neurosonography technique, pathophysiology, and imaging of intracranial insults including hemorrhage, white matter injury, infarction, and hypoxic-ischemic encephalopathy.