The newborn brain is particularly vulnerable to seizures which are associated with poor neurodevelopmental outcome. The clinical manifestations of seizures in infants differ from those seen in older children and adults. The problem of electro-clinical dissociation, where there is no temporal correspondence between electrical paroxysms and repetitive stereotyped motor phenomena, is common in the newborn. There is at present very little information on which clinicians can base a rational decision about treatment which is often ineffective and does not alter neurodevelopmental outcome. This review summarizes current knowledge regarding investigation, treatment and prognosis of neonatal seizures.