Neonatal cerebral infarction in term infants has many possible causes, including bacterial meningitis, inherited or acquired coagulopathies, trauma, and hypoxia-ischemia. However, a specific cause often cannot be identified. Neurologic symptoms in the neonatal period are often subtle and nonspecific, even in infants with large infarctions involving an entire cerebral artery distribution. The most common presenting symptom is focal motor seizures of the contralateral limbs. Cranial magnetic resonance imaging, especially with diffusion-weighting, is the most sensitive imaging modality, although ultrasonography with Doppler imaging of cerebral blood flow is useful in the neonate who is too ill to transport. Neurodevelopmental outcome is often surprisingly good, with many infants making a complete recovery of motor function. The effect of neonatal stroke on cognitive function, especially language acquisition and emotional and social development, has not been fully established.