Cranial sonography continues to hold an important place in neonatal care. Attributes favorable to sonography that make it almost indispensable for routine care of the newborn includes easy access, low cost, portability, lack of ionizing radiations and exemption from sedation or anaesthesia. Cranial sonography has high impact in management of neonates suspected to have hemorrhage; hypoxic/ischemic injury ; complications of CNS infections; hydrocephalus resulting from multitude of causes and congenital anomalies. Also color Doppler plays an important role in diagnosis and follow-up of brain damage secondary to ischemia and diagnosis of vascular thrombosis. This presentation provides a quick roadmap to spectrum of pathological imaging appearances encountered in neonates including intra cranial hemorrhage, hypoxic-ischemic brain injury in the term and near-term infant, hydrocephalus, congenital structural anomalies, intracranial vascular lesions and to obtain insight into the severity of lesions and for better prognostication, it is recommended that a scoring system be applied. Also we discuss about Scanning protocols, timing and serial examinations to obtain optimal information from US serial, both in preterm and sick full-term infants.